This document provides information about colostomy care, including:
1. A colostomy is a surgical procedure that diverts the colon through an opening in the abdominal wall to remove a damaged part. Proper care of the stoma, pouch, and surrounding skin is needed to prevent infection and promote comfort.
2. Indications for a colostomy include birth defects, inflammatory bowel disease, injuries, blockages, cancers, and wounds.
3. The location of the stoma depends on the type of colostomy, which can be ascending, transverse, descending, or sigmoid. Proper assessment of the stoma and skin is important to monitor health.
Colostomy is a surgically created open in the colon for the purpose of evacuation of bowel.
Colostomy care is the maintenance of hygiene by regular emptying of colostomy bag and cleaning colostomy site.
Colostomy is a surgically created open in the colon for the purpose of evacuation of bowel.
Colostomy care is the maintenance of hygiene by regular emptying of colostomy bag and cleaning colostomy site.
In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into the bladder through the urethra. Catheterization allows urine to drain from the bladder for collection. It may also be used to inject liquids used for treatment or diagnosis of bladder condition
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In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into the bladder through the urethra. Catheterization allows urine to drain from the bladder for collection. It may also be used to inject liquids used for treatment or diagnosis of bladder condition
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Stoma care,child,
Helps both UG and PG nursing students
Helps in knowing how to care for a stomal site
daily activities with stoma.
Dietary guidelines for a child with stoma
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#Nursing Care.
This topic is Related to the nursing care of colostomy patient. This slide includes the nursing diagnosis also. Share with other nursing students.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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2. Meaning & Purpose
• Colostomy - A surgical procedure in which the colon is
shortened to remove a damaged part and the cut end
diverted to an opening in the abdominal wall.
• Colostomy care- The pouch, stoma, and skin
surrounding the stoma require care and maintenance.
Purpose:
To maintain integrity of stoma and peristomal skin.
To prevent infection.
To promote general comfort and positive self-image.
To provide clean ostomy pouch for fecal evacuation.
To reduce odor from overuse of old pouch.
3. Indication for Colostomy
• Birth defect
• Inflammatory bowel disease
• Injury to the colon or rectum
• Partial or complete intestinal or bowel blockage
• Rectal or colon cancer
• Wounds or fistulas in the perineum
5. Location of Stoma
• The ascending colostomy is located on the right side
of the abdomen.
• The transverse colostomy is in the upper abdomen,
either in the middle or toward the right side of the body
• Descending or sigmoid colostomy is located on the
lower left side of the abdomen.
6. What to expect ?
Ascending
colostomy
Transverse
colostomy
Descending
colostomy
Sigmoid
colostomy
Liquid
Digestive enzyme
Semi solid
Digestive enzyme
Resembles normal
bowel movement
Resembles normal
movement
7. Assessment
• Size:
Round - measure using stoma measuring guide
Oval - measure length and width
• Colour:
Red - adequate blood supply
Pale - low haemoglobin
Dark red/purplish tint - indicates bruising
Grey to black - no blood supply
Other - Appearance healthy - Shiny & moist
8. Assessment - Peristomal skin
• Colour
Healthy - no difference from adjacent skin surface
Erythema - red
Bruised - purplish to yellowish colour
• Integrity
Intact - no breakdown in skin
Macerated - white friable skin, too much moisture
Erosion - superficial skin damage
Rash - an outbreak of lesions on the skin
Ulceration - a wound through the dermis layer
Other - Turgor normal (soft, good elasticity)
Flaccid - weak flabby, firm - hard
9. Assessment- Stoma
• Stoma Colour:
Normal - Pink/red/warm to touch
Abnormal - black/dusky/pale/sloughy
• Skin:
Normal - In the post-operative period the stoma can be
quite swollen. It may reduce in size for about 6 weeks
after surgery.
Abnormal - Any sudden or unexplained swelling of the
stoma
• Bleeding Stoma:
Normal - A slight smear of blood on the wipe when
washing or drying the stoma.
Abnormal - Excessive bleeding when cleaning the
stoma/blood in the pouch/bleeding from inside the
10. Pre- procedure preparation
• Detailed history taken down: current complaint, history of
presenting illness, past medical history (co-morbidities),
surgical history, social and environmental history.
• Medications and allergies documented.
11. Procedure
Measure the stoma if the ostomy is new or use the
previously cut pattern.
Place pattern on the back of the ostomy bag and draw
the proper size opening. Do not cut more than one bag
for next ostomy change if the stoma is still shrinking.
Place a finger inside the bag to prevent cutting through
the bag when cutting the hole into the wafer. The wafer
should fit just around the stoma in order to minimize the
amount of skin exposed.
12. You should not apply the wafer if too much skin is left
exposed to stool drainage. You can always cut the wafer
larger if it is too small at first.
Empty contents of bag.
Remove old bag and stoma wafer, by using adhesive
remover or gently pulling bag away from skin and placing
your hand on the skin to decrease pulling on the skin.
The skin may look dark pink when the bag is first removed.
This fades quickly.
13. Discard the bag. Put the bag in a small "baggie" before
putting it in the trash.
Pat the skin around the stoma with gauze soaked in normal
saline.
Inspect the skin for signs of rash, irritation or breakdown.
When skin is clean and dry, apply skin prep ( as
prescribed) around the stoma site and let dry until it gets
sticky. Warm the wafer attached to the bag by gently rub it
between your hands to help the wafer mold to the skin.
14. Touch the skin around the stoma. Reapply the skin prep if
the skin is longer sticky.
Take the paper off the back of the wafer and place the bag
around the stoma.
Gently press the bag in place with your hand to help the
wafer mold to skin.
Smooth out end of bag, fold it two times and put on the
clamp if the bag does not have a Velcro closure.
If the edges of the wafer are not sticking to the skin:
- Rub skin prep on the edges of wafer.
- Use mesh tape (as prescribed) to tape the edges of
the wafer to the skin.
15. Health education
• Black or dark gray in color (necrotic): this usually
indicates a lack of adequate blood supply to the stoma
and requires immediate intervention.
• Bleeding: the stoma may have suffered trauma or your
child may have internal bleeding.
• Obstructed: blockage of ostomy seen by a small amount
to no stool.
16. Warning Signs & Complications
• Warning signs:
! Bleeding from stoma.
! Bleeding from the skin around the stoma.
! Change in the bowel pattern.
! Change in the stoma size.
! Increased in the temperature
• Complications:
! Leakage.
! Prolapse.
! Obstruction or stenosis.
! Stoma become edematous and enlarged.