40. Suppositories

Learning outcomes

By the end of this section, you should know how to:

▪ prepare the patient for this nursing practice

▪ collect and prepare the equipment

▪ administer rectal suppositories

▪ describe some of the types of suppository and their function.

Background knowledge required

Revision of the anatomy and physiology of the colon, rectum and anus

Revision of ‘Administration of medicines’, particularly checking the medication against the prescription (seep. 13)

Common causes of constipation

Appropriate health education in relation to the prevention of constipation.

Indications and rationale for administering suppositories

A suppository is a cone or cylinder of a medicinal substance that can be introduced into the rectum, will eventually dissolve and may be absorbed through the rectal mucosa. It is used:

▪ to relieve constipation

▪ to evacuate the bowel prior to surgery or certain investigations

▪ to treat haemorrhoids or anal pruritus

▪ to administer medication, e.g. antibiotics, bronchodilators or analgesics.

An appropriately trained nurse prescriber has the ability to assess, diagnose and prescribe an appropriate suppository to rectify severe constipation. This is a specialised extended role, recognised by a registerable qualification with the Nursing and Midwifery Council. An awareness of the Rome II criteria for constipation (seep. 130) offers guidance to the practitioner when diagnosing constipation, as will a digital rectal examination (DRE; seep. 289).

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Equipment

1. Tray/flat surface

2. Disposable gloves

3. Apron

4. Medical wipes/tissues

5. Water-soluble lubricant

6. Protective covering

7. Receptacle for soiled disposable items

8. Prescribed suppository

9. Access to toilet facilities.

Suppositories are of value in evacuating the rectum. Glycerine suppositories lubricate dry, hard stools and have a mild stimulant effect on the rectum. Other suppositories with a stimulant effect are Beogex® and bisacodyl.

Medication is well absorbed through the rectal mucosa and is of benefit for patients who may be unable to swallow medication, e.g. during an epileptic seizure; severe nausea and vomiting; low level of consciousness.