5.6.3: Rectal Route
- Page ID
- 89403
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)The rectal route is used when the patient cannot tolerate oral drugs due to nausea or vomiting. The rectal route is also used to relieve constipation.
Supplies and equipment required to administer drugs orally include:
- Provider’s drug order
- Documentation system
- Gloves and other appropriate personal protective equipment (PPE)
- Drug supply
- Water soluble lubrication
- Paper towels or tissues
When preparing rectal drugs, practice medical asepsis and work in a well-lit area without distractions. Follow the nine rights of drug administration and check for drug allergies. Only administer drugs ordered by the provider and that you have prepared yourself. If the MA has any questions about the drug, do not administer the drug until all questions have been answered.
Follow the following steps for safe administration of sublingual and buccal drugs:
- Use a drug reference source to review information on the drug ordered.
- Calculate the amount of drug to be administered
- Wash your hands.
- Check the drug label against the provider's order. Check for the drug name, form, and route.
- Check the expiration date on the drug packaging.
- For bulk tablets, remove the container's cover and pour the correct number of suppositories into the cap. It is acceptable to pour extra suppositories back into the container only if they are in the container's cap.
- When the correct number of suppositories is in the cap, pour the tablets into the paper medicine cup.
- For unit doses, tear the foil or plastic packaging and drop the suppository into the medicine cup.
- Place the medicine cup on the medication tray and clean up the work area
- Perform another check for the right name, form, route, and dose.
- Greet the patient and identify yourself. Verify the patient’s identity by asking for their name and date of birth. Check the patient’s identification bracelet if required.
- Ask the patient if they have any drug allergies.
- Provide patient education. Explain the drug ordered, the indication for the drug, side effects, adverse effects, and the provider who ordered the drug.
- Explain the procedure to the patient. Instruct the patient that they will be asked to retain the suppository for 10 minutes before they can use the toilet. When the suppository is inserted into the rectum, they may feel a bit of pressure; this is normal. Instruct the patient not to flush the toilet when 10 minutes have elapsed after suppository insertion.
- Perform any assessments prior to administering the drug
- Allow the patient to ask questions.
- Allow for patient privacy. Ask the patient to disrobe from the waist and provide a paper drape.
- Ask the patient to lie on the examination table on their left side. Ask the patient to raise their right knee as far as is comfortable.
- Apply water-soluble lubrication to the suppository.
- Tell the patient when you are about to insert the suppository and ask them to take a deep breath and relax. With a gloved hand, insert the suppository 1-2 inches into the rectum. Provide emotional comfort to the patient.
- Wipe any lubricant from the patient's anal area with a paper towel or tissue. Remind the patient they are expected to hold in the suppository for 10 minutes.
- After 10 minutes, help the patient to the toilet and remind them not to flush.
- After the patient uses the toilet, examine the return upon toileting and include this in the patient’s health record documentation.
- Document the procedure in the health record, along with the patient's response to the procedure.