Colostomy care

colostomy care for nurses

1. COLOSTOMY CARE Rohini Pandey 1 st Year M.Sc Nursing KGMU Institute Of Nursing

2. CONTENTS Definition Types of colostomy Indication of colostomy Articles required for colostomy Procedure Complication

3. INTRODUCTION

4. DEFINITION Colostomy is an opening, called a stoma in the large intestine brought to the surface of the abdomen for the purpose of evacuation of bowel.

5. TYPES OF COLOSTOMY ACCORDING TO DURATION Permanent Colostomy Temporary Colostomy

6. ACCORDING TO STOMA SITE Ascending Colostomy Transverse Colostomy Descending Colostomy

7. ACCORDING TO STOMA NUMBER & TYPE Single – Barrel Colostomy Double – Barrel Colostomy Loop Colostomy

8. INDICATION FOR COLOSTOMY Colon Cancer Hirschprung’s Disease Ulcerative Colitis Polyps in Intestine

9. PURPOSE OF COLOSTOMY CARE Skin protection & care Receptacle for drainage Patient acceptance & self care

10. ARTICLES REQUIRED

11. A clean tray containing Mackintosh with draw sheet Kidney tray/paper bag Pair of clean gloves Colostomy bag NS/Basin with warm tap water Gauze pieces Gauze pad/tissue paper Skin barrier Stoma measuring guide Pen or pencils & scissors Bed pan

12. PROCEDURE PROCEDURE Gather equipment. Encourage clients to look at the stoma. Explain the procedure to the patient. Provide privacy. Perform hand hygiene & wear gloves. RATIONALE Ensure that everything is there to render the care. It encourages participation in the stoma care. To gain confidence of the patient. For smooth performance of procedure. To prevent infection.

13. PROCEDURE Spread mackintosh & draw sheet. Remove used pouch & skin barrier gently by pushing the skin away from the barrier. Remove clamp and empty the content into bed pan. Rinse the pouch with tepid water/NS. Discard the disposable pouch in paper bag. RATIONALE To protect linen. Reduces trauma, jerking, irritates skin & can cause tear. To minimize the odour & growth of microbes.

14. PROCEDURE Observe stoma for colour, swelling, trauma & healing. Stoma should be moist & pink. Cover the stoma with a gauze piece. Clean peristomal region gently with warm tap water using gauze pad. Don't scrub the skin, dry by patting the skin. Remove gauze & clean stoma with gauze RATIONALE To find out complications. To prevent the faecal matter from contacting with skin. Stoma surface is highly vascular. Skin barrier does not adhere to wet skin. -do-

15. PROCEDURE Measure the stoma using measuring guide. Trace same circle behind the skin barrier, using scissors, cut an opening 1/16 to 1/8 inch larger than stoma before removing the wrapper over adhesive part. Put skin barrier & pouch over the stoma, & gently press on to the skin, for 1-2 min. RATIONALE Ensure accuracy in determining correct pouch size needed. -do- To prevent irritation to skin.

16. PROCEDURE Use the pouch if it is drainable using a clamp or clip. Remove gloves and wash hands. Make the patient comfortable. Clean the area and replace all articles.

17. DOCUMENTATION Record the procedure with following details: Date/Time Amount Colour Consistency of faecal matter Sign of any infection

18. COMPLICATION Necrosis of Stoma Retraction of Stoma Prolapsed of stoma Stenosis or Narrowing Parastomal hernia

19. CLIENT & FAMILY EDUCATION Balanced diet Yoghurt or buttermilk to reduce gas formation Drink 6-8 glasses of fluids daily. Education for self care like Applying & Emptying Of pouch. Bathing Wearing of pouch Reducing odour

20. SUMMARIZATION