Rectal Suppositories and Ointments
A rectal suppository is a small, solid, medicated mass, usually cone-shaped, with a cocoa butter or glycerin base. It may be inserted to stimulate peristalsis and defecation or to relieve pain, vomiting, and local irritation. Rectal suppositories commonly contain drugs that reduce fever, relieve constipation, induce relaxation, interact poorly with digestive enzymes, or have a taste too offensive for oral use. Rectal suppositories melt at body temperature and are absorbed slowly.
Because insertion of a rectal suppository may stimulate the vagus nerve, this procedure is contraindicated in patients with potential cardiac arrhythmias. It may also have to be avoided in patients with active rectal bleeding or who have undergone recent rectal or prostate surgery because of the risk of local trauma or discomfort during insertion.
An ointment is a semisolid medication used to produce local effects. It may be applied externally to the anus or internally to the rectum. Rectal ointments commonly contain drugs that reduce inflammation or relieve pain and itching.
Equipment
Rectal suppository or ointment ▪ applicator ▪ patient’s medication record and chart ▪ gloves ▪ water-soluble lubricant ▪ 4″ × 4″ gauze pads ▪ Optional: bedpan.
Preparation of Equipment
Store rectal suppositories in the refrigerator until needed to prevent softening and, possibly, decreased effectiveness of the medication. A softened suppository is also difficult to handle and insert. To harden a softened suppository, hold the suppository (in its wrapper) under cold running water.
Implementation
Avoid distractions and interruptions when preparing and administering the medications to prevent medication administration errors.1
Verify the order on the patient’s medication record by checking it against the doctor’s order.2
Compare the medication label to the doctor’s order to verify the correct medication, indication, dose, route, and time of administration.2
Check the expiration date on the medication; don’t give the drug is it’s expired.2
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.6
Provide privacy.
Explain the procedure and the purpose of the medication to the patient. If the patient is receiving the medication for the first time, inform the patient or his family about the significance of adverse reactions or other concerns related to administering the medication.2
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