6.13. Steps and procedures for the different routes of Medication Administration(Insertion).


Insertion: rectal/vaginal suppositories or creams


 Rectal Suppository – A rectal suppository is a medicine shaped like a cone or cylinder that is inserted into the rectum. It is made of a waxy substance that melts easily. To administer a rectal suppository:

  • Provide privacy for the client.
  • Wash your hands thoroughly.
  • If the suppository is soft; hold it under cool water to harden it before removing the wrapper. Remove the wrapper.
  • If you are to use half of the suppository, cut it lengthwise.
  • Put on a finger cot or a disposable glove.
  • Lubricate the suppository tip with a water-soluble lubricant such as KY Jelly.
  • Assist the individual to lie on their left side with their lower leg straightened out and upper leg bent forward toward their stomach. The colon is on the left side of the body and the suppository will enter the lower GI tract more easily.
  • Lift upper buttock to expose the rectal area.
  • Insert the suppository, pointed end first, with your finger until it passes the muscular sphincter of the rectum, about 1 inch in adults. If not inserted past the sphincter, the suppository may pop out.
  • Hold buttocks together for a few seconds. Ask the individual to remain lying down for about 15 minutes to avoid having the suppository come out. Instruct the client to not to “bear down,” and to hold in the suppository for as long as possible.
  • Discard used materials and wash your hands thoroughly. to prevent the suppository from being expelled.


   Vaginal Suppository or cream–


  • Wash your hands thoroughly.
  • To use the cream, fill the applicator that comes with the cream to the level indicated.
  • To use the suppository, unwrap it, wet it with lukewarm water, and place it on the applicator shown with the accompanying instructions.
  • Assist the client to lie on her back with knees drawn upward and spread apart. in a “frog leg” position (dorsal recumbent position).
  • Insert the applicator high into the vagina (unless she is pregnant), and then push the plunger to release the medication. Vaginal suppositories are inserted 2-3 inches into the vaginal orifice. Body temperature will melt the suppository to aid in the absorption of the medication. To insert a vaginal cream, grasp the barrel of the applicator. Place the thumb on the plunger. Pointing the applicator slightly downward, insert the applicator into the vagina as far as it will comfortably go.
  • Push the plunger with the thumb as the applicator is slowly removed from the vagina.
  • If she is pregnant, insert the applicator gently. If you feel resistance (hard to insert), do not try to insert it further; notify the doctor.
  • Withdraw the applicator.
  • Instruct the client to remain lying down for 15-30 minutes for absorption of the medication. Vaginal creams/suppositories are best administered at bedtime. Pull the applicator apart and clean it with soap and warm water after each use.
  • Wash your hands thoroughly.


        NOTE: The dose should be applied when the client lies down to go to bed. The medicine works best if she does not get up again after applying it. You may to provide a sanitary napkin to protect clothing against stains.