Question
of the Week

• Explanation

Pediatric administration of rectal suppositories is similar to adult administration, with a few modifications due to the small size of a child's colon and varying developmental needs. Age-appropriate explanations and/or distractions should be implemented to reduce distress.

Steps for suppository administration include the following:

• Place the client in the Sims position (side-lying with the knees bent) (Option 1).
• Lubricate the tip of the suppository and finger.
• Insert the suppository using a gloved index finger if the client is older than age 3 (Option 3).
• Angle the suppository and guide it along the rectal wall. The suppository should remain in contact with the rectal mucosa, and not be buried inside stool, to ensure systemic absorption (Option 2).
• Hold the buttocks together for several minutes, or until the urge to defecate has passed, to prevent immediate expulsion (Option 5).
• If a bowel movement occurs within 10-30 minutes, observe for the presence of the suppository.

(Option 4) The suppository must be inserted past both the external and internal sphincters for proper placement. If not inserted far enough, it may be expelled before achieving a therapeutic effect.

Educational objective:
When administering a rectal suppository to clients older than age 3, place the client in the Sims position, use a gloved index finger to insert the suppository past the internal sphincter, guide the suppository along the rectal wall, and ensure the suppository is not immediately expelled.

Lecture References :

• Fundamentals - Positioning