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Teaching Sheets Four
Rectal Administration of Medications
Seizures
Swelling (Edema)
Urinary Incontinence
Unconsciousness
Weakness

 
Rectal Administration of Medications

Most medications for pain and symptom management can be administered orally however some medications may have to be given rectally. Some reasons for rectal administration are:

  • The patient is having episodes of nausea and vomiting.
  • The patient has difficulty swallowing.
  • The patient is in the last days of his/her life and is comatose. It I never advisable to stop pain medications at this time for fear that the patient may experience pain and be unable to communicate this to us. Most medications that are ordered to be given by mouth can also be absorbed rectally.
Steps for giving rectal medication:
  • Wash your hands and put on gloves.
  • If the medication is in suppository form, remove the foil and put a large amount of Vaseline or gel on the suppository.
  • A pill or capsule can be inserted directly into the rectum by either applying Vaseline or placing the pill or capsule into a gelatin capsule. (the gelatin capsules can be purchased at your drug store)
  • If possible place the patient on his/her left side with their knees pulled up. Have the patient relax as you gently insert the medicine into the rectal opening with your gloved hand.
  • Push the medicine into the rectum as far as it will go.
  • If there is stool in the rectum, the patient will need to have a bowel movement before the medicine can be put into the rectum.
  • If the patient is impacted and unable to go on their own, call the hospice nurse for help.
  • Please call Hospice with any questions.
 

Seizures

Definition: A seizure or epilepsy is a disorder characterized by convulsive movement of muscles and loss of consciousness after which the patient has a period of confusion or sleepiness.

Problems

  • Seizures are frightening
  • Injuries can occur
Causes
  • High fevers
  • Injury to the head
  • Tumor growth in the spine or brain
  • Infection in the spine and surrounding the brain
Treatments
  • Medications as directed by your physician
  • Support and protection during a seizure
  • Do not restrain the patient during a seizure (this can cause injury)
  • Ease the patient to the floor
  • Place a pillow along the side rails if the patient is in bed
  • Do no place anything in the mouth
  • After a seizure
    • Turn the patient's head to the side and make the patient comfort
    • Reorient the patient to the environment
    • Administer oral hygiene
Helpful Tips:
 
 
 
 

Swelling

Definition: Swelling is an accumulation of fluid in the tissues (medical term) Edema.

Problems – Swelling can cause:

  • Pain
  • Interference with mobility
  • Injury to edematous skin (skin breakdown)
Causes
  • Salt and water retention due to heart, kidney or liver problems
  • Malnutrition
  • Tumor obstruction to the veins or lymph system
Treatments
  • Low salt diet
  • Elevate your legs on pillows while in bed
  • When in a chair keep your legs up and supported from the knees down
  • Change position in bed often if bedbound
  • Take medications as directed by your physician
Helpful Tips:
 
 
 
 

Urinary Incontinence

Definition: Urinary incontinence is the inability to retain urine.

Problems – Urinary incontinence can cause:

  • Skin excoriation and breakdown
  • It can be painful
  • It can be embarrassing
Causes
  • Infection
  • Weak muscle tone
  • Need to get to the bathroom sooner
  • Tumors of the bladder
Treatments
  • Medications as directed by your physician
  • Insertion of an indwelling catheter
  • Assist to the bathroom more often
  • If patient is too weak to get to the bathroom, have a bedside commode next to the bed
Helpful Tips:
 
 
 
 

Unconsciousness

Definition: Unconsciousness is a condition in which the patient does not respond.

Problems

  • Unable to communicate their wishes
  • Unable to eat or swallow
  • Immobility which can lead to bedsores
  • Dry mouth due to dehydration
Causes
  • Lack of oxygen to the brain
  • Changes in the metabolic balance due to decrease in intake
  • Tumor spread to the brain
  • Impending death
Treatments
  • Remember the Patient can still hear, so orient the patient by explaining who you are, what time of day it is, where he or she is and what you are doing during your care.
  • Turn the patient every 2 hours to prevent pressure sore.
  • Keep the lips moist and place ice chips or water droplets in the side of the patient's mouth.
  • Use natural tears or normal saline in the eyes to keep them moist.
  • Talk and touch the patient as if they were still conscious so they know you are there and they are not alone.
Helpful Tips:
 
 
 
 

Weakness

Definition: Weakness is the lack of physical strength, vigor or energy to do what you normally do.

Problems – Weakness can cause:

  • Falls and injury
  • Inability to perform activities of daily living (ADL)
  • Decrease desire for socialization
  • Sadness
Causes
  • Poor food and fluid intake
  • Disease process
  • Insomnia
  • Depression and anxiety
Treatments
  • Rest between activities
  • Schedule activities as tolerated and at times of the day that the patient appears more rested
  • Eat foods high in protein
  • Increase fluid intake as tolerated
  • Use assistive devices to ambulate and provide a sense of security
  • Medications if necessary for anxiety and/or depression
Helpful Tips:
 
 
 
 
 
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