A nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client's discomfort?

A. Lower the height of the solution container: Cramping during an enema is usually caused by the solution flowing too fast or the colon distending too rapidly. The speed of the flow is determined by gravity (the height of the bag). Lowering the bag slows the infusion rate, which typically relieves the cramping, allowing the nurse to continue the procedure safely. B. Allow the client to expel some fluid before continuing: If the client expels the fluid immediately, the enema will not be effective because the solution has not been retained long enough or reached high enough into the colon to break up the fecal impaction. C. Encourage the client to bear down: Bearing down increases intra-abdominal pressure and promotes defecation. The goal at this stage is retention of the fluid, not expulsion. D. Stop the enema and document that the client did not tolerate the procedure: Cramping is a common and manageable side effect. Stopping the procedure completely is premature; the nurse should attempt to alleviate the discomfort (by slowing the flow) first.