A nurse is preparing to administer a Fleets saline enema to an adult client. Which of the following is an appropriate nursing action?

Choice A rationale Positioning the client in the left Sim's position is an essential step when administering an enema. This position utilizes gravity to help the enema solution flow downward following the natural curve of the sigmoid colon and rectum, facilitating better retention of the fluid and optimal distribution for effective bowel evacuation. Choice B rationale Enema administration is considered a clean procedure, not a sterile one, because the colon and rectum are not sterile environments. Therefore, the use of non-sterile (clean) gloves is appropriate and sufficient for this procedure to ensure proper hygiene and prevent the transmission of microorganisms, making sterile gloves unnecessary. Choice C rationale For an adult client, the tubing or tip of a prepackaged enema should only be inserted about 3 to 4 inches (7.5 to 10 cm) into the anus, following the direction of the umbilicus. Inserting the tubing 6 inches is too far, increases the risk of perforation or injury to the rectal mucosa, and is not the correct technique for safe administration. Choice D rationale A Fleets saline enema is a pre-packaged, pre-filled disposable unit that is administered by gently squeezing the bottle, not by gravity from a container bag. Therefore, hanging an enema container 24 inches above the anus is the procedure for a large-volume gravity enema, not the small-volume pre-mixed Fleets enema.