Colostomy irrigation

Colostomy Irrigation

1. COLOSTOMY IRRIGATION 30/08/2020 Darwina I Halbi MAN 1 Prepared By DARWINA IRIBANI HALBI RN MAN Ateneo De Zamboanga University Zamboanga City Philippines

2. COLOSTOMY IRRIGATION 30/08/2020 Darwina I Halbi MAN 2

3. COLOSTOMY IRRIGATION Colostomy irrigation is a way to regulate bowel movements by emptying the colon at a scheduled time The process involves infusing water into the colon through the stoma. This stimulates the colon to empty. By repeating this process regularly— once a day or once every second day — the colon can be trained to empty with no spillage of waste in between irrigation. Colostomy irrigation also can help avoid constipation. 30/08/2020 Darwina I Halbi MAN 3

4. COLOSTOMY IRRIGATION Objectives To empty and cleanses the colon and rectum To stimulate peristalsis and help develop regular bowel movement. To relieve flatulence . 30/08/2020 Darwina I Halbi MAN 4

5. COLOSTOMY IRRIGATION Indications Accomplished after surgery to promote regulated evacuation. To regulate bowel movement To help avoid constipation 30/08/2020 Darwina I Halbi MAN 5

6. COLOSTOMY IRRIGATION Nursing Alert: The danger of the perforation of the colon is much greater when irrigating a colostomy with a catheter. The use of an irrigation cone usually results in safer administration and better water flow. 30/08/2020 Darwina I Halbi MAN 6

7. COLOSTOMY IRRIGATION Equipment can be kept at the patient’s bedside or in the bathroom. Irrigation kit (irrigation bag with clamp and tubing, cone-tip irrigation catheter, irrigation drain pouch). Water soluble lubricant. IV pole (or other suspending hook). Draw Sheet or CHUX 30/08/2020 Darwina I Halbi MAN 7

8. COLOSTOMY IRRIGATION Equipment can be kept at the patient’s bedside or in the bathroom. Soap and water. Washcloth and towel. Ostomy appliance Waste receptacle. Prescribed irrigating solution, usually 500-1000cc warm (100º–105ºF) tap water. 30/08/2020 Darwina I Halbi MAN 8

9. Nursing responsibilities before the procedure Verify patient’s identity. Introduce self. 2. Explain procedure to the patient. Gather Equipment Practice Hand hygiene. Don gloves. Provide Privacy 30/08/2020 Darwina I Halbi MAN 9

10. Nursing responsibilities before the procedure If the patient is ambulatory, have the patient sit on the toilet or on a chair facing the toilet. If the patient is bedridden, elevate the HOBº 45-90ºand position Chux around the patient. 30/08/2020 Darwina I Halbi MAN 10

11. DURING THE PROCEDURE 1. Fill the irrigation bag with the prescribed solution and hang it on the IV pole or hook. (a.) The bottom of the bag should be at the patient’s shoulder level when he is seated to prevent fluid from entering the bowel too rapidly. (b.) The bottom of the bag should be placed 18 to 20 inches above the stoma when the patient is in bed. 30/08/2020 Darwina I Halbi MAN 11

12. COLOSTOMY IRRIGATION 7. Open the clamp on the irrigation tubing and allow the solution to fill the tubing. Reclamp . (This prevents the administration of air into the intestines.To release air bubbles in the set-up so that air is not introduced into the colon which would cause crampy pain.) 30/08/2020 Darwina I Halbi MAN 12

13. COLOSTOMY IRRIGATION 8. Prepare to begin the colostomy irrigation. a. Remove the ostomy pouch, if applicable, and place the irrigation drain pouch over the stoma. (Attach stoma belt if required.) b. Place the bottom, open end of the irrigation drain pouch in the toilet (or bedpan) to facilitate drainage by gravity. c. Connect the cone-tip catheter to the tubing and flush with solution. 30/08/2020 Darwina I Halbi MAN 13

14. COLOSTOMY IRRIGATION 9. Lubricate the cone with the water-soluble lubricant to avoid irritating the mucous membranes. 30/08/2020 Darwina I Halbi MAN 14

15. COLOSTOMY IRRIGATION 10. Gently insert the cone into the stoma so that the stoma is occluded. Unclamp the irrigating tubing and allow the water to flow in slowly a. Allow water to enter the colon over a period of 10 to 15 minutes. b. If cramping occurs, slow down the flow rate and ask patient to deep breathe until cramps subside. Cramping during irrigation may indicate that: (b.1) The bowel is ready to empty. (b.2) The water is too cold. (b.3) The flow is too fast. 30/08/2020 Darwina I Halbi MAN 15

16. COLOSTOMY IRRIGATION 11. Clamp the catheter and remove from the stoma. Fold down the top opening of the irrigation drain pouch and secure it in the closed position. 12. Have the colostomy patient sit on or near the toilet for about 15 to 20 minutes so the initial colostomy returns can drain into the toilet. (If the patient is on bed rest, allow the colostomy to drain into the bedpan.) 30/08/2020 Darwina I Halbi MAN 16

17. COLOSTOMY IRRIGATION 13. Close the colostomy irrigation drain pouch with a rubber band or pouch clip, then ambulate the patient, or return him/her to bed. a. Ambulating stimulates elimination, producing improved irrigation return. b. Have the non-ambulatory patient lean forward or massage his/her abdomen to stimulate return. 30/08/2020 Darwina I Halbi MAN 17

18. COLOSTOMY IRRIGATION 15. Gently clean the area around the stoma with mild soap and water. a. Be careful not to rub the skin. b. Rinse and dry the area with a towel. 30/08/2020 Darwina I Halbi MAN 18

19. COLOSTOMY IRRIGATION 16. Provide for the patient’s comfort; remove and dispose of used supplies. Return the equipment to the utility room, clean and return to the proper place. This will control odor and prolong life of the equipment. 30/08/2020 Darwina I Halbi MAN 19

20. AFTER COLOSTOMY IRRIGATION 17. Document findings a. Record the procedure and significant nursing observations in the patient’s clinical record and report it to charge nurse. 1) Note color and condition of stoma and peristomal skin. 2) Record color, consistency, and amount of drainage. 3) Note amount of irrigating solution used. 30/08/2020 Darwina I Halbi MAN 20

21. COLOSTOMY IRRIGATION 18. As recovery progresses, the nursing personnel should gradually assume a more passive role in colostomy care, allowing the patient to assume the active role. 30/08/2020 Darwina I Halbi MAN 21

22. COLOSTOMY IRRIGATION 30/08/2020 Darwina I Halbi MAN 22