Which are appropriate steps for the nurse to take? A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure.

Warm the enema solution prior to installation.
Position the client on the left side with the right leg flexed forward.
Lubricate the rectal tube or nozzle.

The nurse should warm the enema solution because cold fluid can cause abdominal cramping and hot fluid can injure the intestinal mucosa. Option B allows a downward flow of solution by gravity along the natural anatomical curve of the sigmoid colon. Lubrication prevents trauma or irritation to the rectal mucosa. Option D is an appropriate length of insertion for a child. For an adult client. the nurse should insert a tube 3 to 4 inches. The height of the fluid container affects the speed of installation. The maximum recommended height is 18 inches. Hanging the container higher than that could cause rapid installation and possibly painful distention of the colon.