Colostomy Care

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EBIAS, Jean Michelle Z. BSN 3- D September 14, 2012 COLOSTOMY CARE Definition

Materials Needed

Colostomy care - is the management and support of a patient with a surgical opening created in the bladder, ileum, or colon for the temporary or permanent passage of urine or feces, necessitated by carcinoma, intestinal obstruction, trauma, or severe ulceration distal to the site of the incision.

 Clean gloves  Electric or safety razor  Bedpan  Solvent  Moisture-proof bag  Cleaning materials, including tissues, warm water, mild soap (optional), washcloth or cotton balls and towel  Tissue or gauze pad  Skin barrier (optional)  Stoma measuring guide  Pen or pencil and scissors  New ostomy appliance, with optional belt  Tail closure clamp  Deodorant for pouch (optional)

Illustration

Procedure Preparations 1. Assess:  Stoma color  Stoma size and shape  Stoma bleeding  Status of peristomal skin  Amount and type of feces  Complaints  The client’s and family members’ learning needs regarding the ostomy and self-care.  The client’s emotional status, especially strategies used to cope with the ostomy. 2. Determine:  The type of ostomy and its placement on the abdomen.  The type and size of appliance currently used and the special barrier substance applied to the skin. 3. Assemble equipment. 4. Determine the need for an appliance change.  Assess for the leakage of stool.  Ask the client about any discomfort.  Assess the fullness of the pouch. 5. Select an appropriate time to change the appliance.  Avoid times close to meal or visiting hours.  Avoid times immediately after meals or the administration of any medications that might stimulate bowel evacuation. Procedure 1. Introduce yourself and verify the client’s identity. Explain to the client what you are going to do, why it is necessary and how the client can cooperate. Communicate acceptance and support to client. It is

Nursing Responsibilities  Perform the procedure cautiously.  Observe asceptic technique during the procedure.  Assess thoroughly before cleaning the ostomy skin and stoma.  Position patient properly.  Gather the materials needed completely.  Avoid food that can cause intestinal odor like beans, cabbage, egg fish, garlic and onions.  Avoid food that increases intestinal gas like beer, broccoli, cabbage, corn, carbonated drinks, cucumber, dairy products and radishes.  Avoid foods that thickened stools like bananas, bread, cheese, pasta, rice and yogurt.

Sources  Kozier & Erb’s Fundamentals of Nursing Checklist 8th edition.  http://wps.prenhall.c om/wps/media/objec ts/737/755395/colost omy.pdf  https://encryptedtbn3.google.com/im ages?q=tbn:ANd9Gc QyUp8039OaCyDUi 1Uaeh_csEmNJ3jXoCozlLi1 IiyexAdEmuG9urU74  https://encryptedtbn2.google.com/im ages?q=tbn:ANd9Gc QFdCotQxMiuMjU4 8iqTmYQUvEYOYuiJ vWtVMie4Chzlu5IYq bUi-Z-yhg  https://encryptedtbn3.google.com/im ages?q=tbn:ANd9Gc QEjzk9yQdp2nFMFo BzQiwgzuFSJG4O9LHBUIS ZVewM3vOyBtwmyxEhl0  http://medicaldictionary.thefreedic

important to change the appliance competently and quickly. Include support persons as appropriate. 2. Perform hand hygiene and observe other appropriate infection control procedures. Apply clean gloves. 3. Provide for client privacy, preferably in the bathroom. 4. Assist the client to a comfortable sitting or lying position in bed or, preferable, a sitting or standing position in the bathroom. 5. Unfasten the client’s belt, if client is wearing one. 6. Empty and remove the ostomy skin barrier.  Empty the contents of the pouch through the bottom opening into a bedpan or toilet. Do not throw away the clamp.  Assess the consistency and the amount of effluent.  Peel the skin barrier off slowly, beginning at the top and working downward, while holding the client’s skin taut.  Discard the disposable pouch in a moisture-proof bag. 7. Clean and dry the peristomal skin and stoma.  Use toilet tissue to remove excess tool.  Use warm water, mild soap (optional), and a washcloth and towel to clean the skin and stoma. Check agency policy on the use of soap.  Dry the area thoroughly by patting with a towel. 8. Assess the stoma and peristomal skin.  Inspect the stoma for color, size, shape and bleeding.  Inspect the peristomal skin for any redness, ulceration or irritation. 9. Place a piece of the tissue or gauze over the stoma, and change it as needed. 10. Prepare and apply the skin barrier.  Use the guide to measure the size of the stoma.  On the backing of the skin barrier, trace a circle the same size as the stomal opening.  Cut out the traced stoma pattern to make an opening in the skin barrier. Make the opening no more than 1/8 – ¼ inches larger than the stoma.

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 Remove the backing to expose the sticky adhesive side.

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