During a tap water enema, if a client experiences abdominal cramps, what should the nurse do first?

Lowering the height of the solution container is the appropriate response when a client experiences abdominal cramps during a tap water enema. This action reduces the pressure and flow of the solution, which can help alleviate discomfort. High pressure can cause increased cramping as the colon may react to the rapid influx of fluid, so adjusting the height allows for a gentler, more manageable infusion of enema solution.

The other responses can potentially lead to further discomfort. Encouraging the client to bear down could increase cramping and discomfort, as it adds pressure to the abdominal area. Allowing the client to expel some fluid before continuing might not address the immediate discomfort caused by the cramping, and stopping the enema may not be necessary unless the cramps are severe or persistent. Adjusting the height of the container is a proactive step that can help improve the situation for the client while continuing the procedure safely.