COLOSTOMY CARE

Rohini Pandey1st Year M.Sc NursingKGMU Institute Of Nursing

CONTENTS

1.Definition2.Types of colostomy3.Indication of colostomy4.Articles required for

colostomy5.Procedure6.Complication

INTRODUCTION

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

TYPES OF COLOSTOMYACCORDING TO DURATION

• Permanent Colostomy• Temporary Colostomy

ACCORDING TO STOMA SITE

• Ascending Colostomy• Transverse Colostomy• Descending Colostomy

ACCORDING TO STOMA NUMBER & TYPE

• Single – Barrel Colostomy• Double – Barrel Colostomy• Loop Colostomy

INDICATION FOR COLOSTOMY

1.Colon Cancer2.Hirschprung’s Disease3.Ulcerative Colitis4.Polyps in Intestine

PURPOSE OF COLOSTOMY CARE

1.Skin protection & care2.Receptacle for drainage3.Patient acceptance & self

care

ARTICLES REQUIRED

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

PROCEDUREPROCEDURE

1. Gather equipment.

2. Encourage clients to look at the stoma.

3. Explain the procedure to the patient.

4. Provide privacy.5. Perform hand

hygiene & wear gloves.

RATIONALE 1. Ensure that

everything is there to render the care.

2. It encourages participation in the stoma care.

3. To gain confidence of the patient.

4. For smooth performance of procedure.

5. To prevent infection.

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.

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-

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.

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.

DOCUMENTATION

Record the procedure with following details:

• Date/Time• Amount• Colour• Consistency of faecal matter• Sign of any infection

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

CLIENT & FAMILY EDUCATIONBalanced 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 pouchReducing odour

SUMMARIZATION