Stoma or (ileostomy and colostomy )and Nursing Care

what is a stoma and its types and how to apply colostomy

1. Nursing Care for Stoma By: Bakhtyar Omer Abdalla Supervised by : assist prof. dr.Nian H.Esmael

2. Definition of Stoma - A stoma is a surgically created opening on the abdomen allowing waste products to exit the body. - It is required when normal waste pathways are disrupted by medical conditions like cancer or trauma (Burch, 2020).

3. Stoma 1 Diversion of Waste Stomas allow waste to exit the body when the natural pathway is blocked, usually due to surgery, illness, or injury. 2 Temporary or Permanent A stoma can be created for a short period, such as during recovery from surgery, or as a permanent solution for a long-term health condition. 3 Different Types Stomas are classified into different types based on the organ they connect to, such as the colon, ileum, or bladder. 4 Adapting to Life Living with a stoma requires learning how to manage it and adjusting to its impact on daily life.

4. Types of Stoma 1. Colostomy: Created from the colon (large intestine) to divert stool (Burch, 2020). 2. Ileostomy: Formed from the ileum (small intestine) for semi-liquid stool (Brown & Randle, 2021). 3. Urostomy: Diverts urine away from the bladder using small intestine tissue (Williams et al., 2021).

5. Types of Stomas Colostomy Connects the colon to the outside of the body. Ileostomy Connects the ileum (small intestine) to the outside of the body. Urostomy Connects the urinary tract to the outside of the body.

6. Indications for Stoma Creation Type Indications Colostomy Colorectal cancer, diverticulitis, trauma to the colon, bowel obstructions Ileostomy Crohn's disease, ulcerative colitis, after resection of the colon Urostomy Cystectomy, congenital bladder conditions

7. Differences Between Colostomy and Ileostomy Aspect Colostomy Ileostomy Location In large intestine In small intestine Discharge Formed to semi-formed stool Liquid stool Diet Benefit from high fiber Requires low fiber initially Reason For colon issues For small intestine conditions

8. Nursing Care for Stoma Patients Preoperative Care: - Educate about the procedure. - Identify stoma placement with the surgeon and wound care nurse. - Provide emotional support.

9. Postoperative Care: - Assess stoma color, size, and output. - Maintain skin integrity using barrier creams and proper pouching systems. - Teach cleaning techniques and dietary modifications (Burch, 2020). Nursing Care for Stoma Patients

10. Complications of Stomas - Skin irritation from leakage. - Stoma prolapse: Stoma extends too far. - Stenosis: Narrowing of the stoma opening. - Parastomal hernia: Bulging intestines around the stoma. - Necrosis: Blackened or dry stoma (Williams et al., 2021).

11. Stoma Assessment 1 Appearance Inspect the stoma (a moist, pink or red color). 2 Shape Observe the stoma for a round or oval shape, without prolapse or stenosis. 3 Size Ensure the stoma size is consistent with its initial post-surgery measurement. 4 Drainage Note the type and amount and color of drainage from the stoma.

12. Assessing the Skin Around the Stoma Integrity Check for skin irritation, redness, or breakdown around the stoma. Infection Signs Look for signs of infection, including swelling, heat, or discharge. Size Consistency Verify that the skin size around the stoma remains consistent with its initial post-surgery measurement. Odor Note any unpleasant odors from the stoma or the surrounding skin.

13. Nursing Diagnosis Risk for Impaired Skin Integrity Due to leakage, infection, or improper care techniques. Risk for Infection Related to contamination duri ng stoma care or leakage. Deficient Knowledge About proper stoma bag changing skin protection, and odor control. Body Image Disturbance related to altered appearance and function.

14. Planning and Interventions Preventing Skin Breakdown Apply pouch securely, follow proper care techniques, and use skin protectants. Preventing Infection Use aseptic technique during stoma care and pouch changes. Promoting Psychological Well-Being Offer emotional support, resources, and information to help patients adjust to life with a stoma. Educating the Patient Ensure the patient understands how to care for their stoma independently.

15. Application of a Stoma Pouch 1. Prepare materials: Pouch, barrier, scissors, and cleaning supplies. 2. Clean the stoma area with warm water. 3. Measure and cut the wafer to fit the stoma. 4. Apply barrier paste or ring. 5. Center and attach the pouch. 6. Check for leaks and educate the patient (Brown & Randle, 2021).

16. Conclusion - Stoma care requires physical and emotional support. - Nurses play a vital role in assessing and managing stomas. - Proper education and individualized care improve quality of life for patients (Williams et al., 2021).

17. References - Brown, H., & Randle, J. (2021). Stoma care: A guide for nurses and patients. Nursing Practice Journal. - Burch, J. (2020). Fundamentals of Stoma Care. Journal of Clinical Nursing. - Williams, J., Smith, L., & Carter, K. (2021). Managing ostomies: Best practices for healthcare professionals.