suppository

1. Administering a
Vaginal Suppository
Presented By
Mrs.Usha Rani Kandula, MSc(N),
Assistant professor in Adult health nursing, Department of Clinical nursing,
Arsi University, College of health sciences, Asella, Ethiopia, Institutional email:
usharani2020@arsiun.edu.et.

2. VAGINAL INSTILLATIONS
-Medications inserted into the vagina are in the form of suppositories,
creams, gels, ointments, foams, or douches.
-These medications may be used to treat inflammation, infections, and
discomfort, or as a contraceptive measure.
-Vaginal creams, gels, or ointments usually come with a disposable
tubular applicator with a plunger to insert the drug.
-Standard precautions are always used by the nurse when inserting
suppositories.

3. -Body temperature causes the suppository to melt and be absorbed.
-Suppositories are usually inserted with the index finger of a gloved
hand;
-however, small suppositories may come with an applicator and the
suppository is placed in the applicator’s tip.
-Many clients prefer to insert their own vaginal suppository.
-In this case, provide privacy for the client.

4. -After insertion of these preparations, the client may notice drainage
and should be informed that this is expected.
-If a suppository is given to treat infection, tell the client that the
drainage may be foul smelling.
-The nurse should advise the client to wear a perineal pad to prevent
soiling of the underpants.
-Sterile technique is usually required by agency policy, especially if
there is an open wound when administering a vaginal douche
(irrigation).

5. -Douches are ordered to apply antimicrobial solutions, to remove
offensive or irritating discharge, to reduce inflammation, and to prevent
hemorrhage with warm or cold irrigations.
-The nurse should ensure that the client does not have an allergy to
iodine because many vaginal preparations contain povidone-iodine.

6. Equipment
 Medication administration record (MAR)
 Prescribed vaginal suppository
 Disposable applicator
 Non sterile gloves
 Water-soluble lubricant
 Tissue

8. Sl.No Action Rationale
1 Check with the client and the chart for
known allergies or medical conditions
that would contraindicate the use of the
drug.
Prevents occurrence of adverse reactions.
2 Gather necessary equipment. Promotes efficiency.
3 Check the MAR against written health
care
practitioner orders.
Ensures accuracy in identification of
medication.
4 Wash your hands. Reduces the transmission of
microorganisms.
5 Follow the rights of medication
administration.
Check the client’s identification band.
Ensures correct client.

9. Sl.No Action Rationale
6 Ask the client to void. A full bladder may cause discomfort and
injury
to vaginal lining when suppository is
inserted.
7 Position the client in a dorsal
recumbent position with knees flexed
and hips rotated laterally or in a Sims’
position if the client cannot maintain the
dorsal recumbent position.
Provides good access to vaginal canal,
facilitating insertion of suppository, and
allows suppository to dissolve without
becoming dislodged.
8 Don nonsterile gloves. Decreases contact with body fluids.
9 -Explain procedure to patient. If client
plans to self-administer, be very
specific with instructions.
-Provide for privacy.
Promotes understanding and ensures
cooperation.

10. Sl.No Action Rationale
10 Assess perineal area, inspect vaginal
orifice,
note any odor or discharge from the
vagina, and inquire about any problems
such as itching or discomfort.
Assessment data provide a baseline for
monitoring the effectiveness of the
medication.
11 If secretion or discharge is present,
cleanse the perineal area with soap
and water.
Prevents introduction of microorganism
into
vagina.
12 -Remove suppository from the foil
wrapper and, if applicable, insert into
applicator tip.
-Apply a small amount of lubricant to
rounded tip of suppository.
-If not using an applicator, apply a
small amount of lubricant to gloved
index finger.
Facilitates insertion; reduces mucosal
irritation.

11. Sl.No Action Rationale
13 -With nondominant hand, spread labial
folds.
-Insert the suppository into the vaginal
canal at least 2 inches (5 cm) along the
posterior wall of the vagina or as far as
it will go (Figure 29-39).
-If using an applicator, insert as
described above and depress plunger
to release suppository.
Exposes vaginal orifice. Proper placement
ensures equal distribution of medication
and
prevents medication from slipping out.
14 Wipe the perineum with clean, dry
tissue.
Promotes client comfort.
15 Instruct the client to remain in bed for
15 minutes.
Promotes absorption of suppository.

12. Sl.No Action Rationale
16 Wash applicator under cool running
water to clean (warm water promotes
coagulation of protein secretions) and
return to appropriate storage in the
client’s room.
Vaginal cavity is not sterile. Washing will
assist in removal of bacteria and residual
lubricant or
medication.
17 -Remove gloves, turning them inside
out; dispose of gloves in the proper
receptacle. -Wash hands.
Reduces transfer of microorganisms.
18 Record on the MAR the drug’s name
dosage, route, and date and time of
administration; document any evidence
of discharge or odor from the vagina.
Provides documentation that medication
was
given.

13. Thanking you
Sl.No Action Rationale
19 Check with the client in 15 minutes to
ensure that the suppository did not slip
out and to allow the client to verbalize
any problems or concerns.
Decreases client anxiety.
20 Observe for effectiveness of the
medication; inspect the condition of the
vaginal canal and external genitalia
between applications.
Evaluates effectiveness of medication.