Colostomy Care
Juliet Y. Limjoco, RN, MAN
Bowel Diversion Ostomy
• Ostomy – opening for the gastrointestinal,
urinary, or respiratory tract onto the skin
Types of Intestinal Ostomies
1. Gastrostomy – feeding purpose
2. Jejunostomy – feeding purpose
3. Ileostomy – drain fecal material
4. Colostomy – drain fecal material
Types of Colostomy
Indications of Colostomy
1.Colon cancer
2.Obstruction
3.Inflammatory bowel disease
4.Traumatic injury
5.Birth defect
Classification of Bowel Diversion Ostomies
1. Status – permanent or temporary
• Temporary - traumatic injuries or inflammatory
conditions of the bowel
2. Anatomic location
• Ascending, transverse and descending
• Location of ostomies influences the character
and management of fecal drainage
• Length of time helps determine the consistency
of the stool
3. Construction of stoma
• According to number of stoma and type
Colostomy according to Number and
Type
1. Single – one end is brought out of the abdominal
wall
2. Loop – same with single but supported by a
plastic bridge or rubber tubing
3. Divided – two edges of bowel brought out onto the
abdomen but separated from each other
4. Double-barreled - resembles the the proximal
and distal loop of bowel are sutured together
Types of Colostomy
ACCORDING TO STOMA
NUMBER & TYPE
Complications of Colostomy
1. Skin irritation
2. Dehydration
3. Bowel obstruction
4. Retraction – stoma move inward
5. Parastomal hernia – stoma move outward
Colostomy Management
• Care and maintenance of pouch, stoma and skin
surrounding the stoma
Purposes of Colostomy Care
1. Maintain integrity of stoma and peristomal skin
2. Prevent infection
3. Promote comfort and positive self-image
4. Provide clean ostomy pouch for fecal evacuation
5. Reduce odor from overuse of old pouch
Types of Pouching System
1. One-piece ostomy appliance
2. Two-piece ostomy appliance
Kinds of Pouch
1. Closed
2. Drainable
Nursing Considerations in Colostomy
Care
1. Assess the stoma for irritation, changes in
size and color
2. Assess the abdomen for type of pouch to be
use
3. Empty pouch if ½ or ⅓ full
4. Change the pouch every 3 – 7 days
5. Use warm water to clean
6. Assess for allergies or sensitivities –
adhesive, skin barrier, pouch materials
Factors affect the time Pouching
System Seal
1. Sweating
2. Moist and oily skin
3. Weight changes
4. Diet
5. Physical activities
Managing Colostomy Problems
1. Gas (flatulence) – avoid certain foods, eat
regularly, avoid skip meal
2. Odor
a. Foods
b. normal bacteria in the intestine
c. Illness
d. certain medicines and vitamins
Skill 12
1. Explains the procedure to the client.
2. Washes hands
3. Assembles the equipment: colostomy appliance
and pouch set, kidney basin or bedpan, warm
water, soap, gauze pad, cotton balls, cloth or
paper towel, toilet tissues, clean gloves
4. Provides for client’s privacy.
5. Assists to a comfortable sitting or side-lying
position in bed or bathroom.
6. Wears disposable gloves.
7. Put Kelly pad or kidney basin alongside the
colostomy bag. Empties colostomy bag into
kidney basin or bedpan by removing clips/cuffs
attached at the end and folding the bag down
8. Slowly removes the colostomy appliance while
keeping the skin taut. Warm water or adhesive
solvent e.g. baby oil may be used to facilitate
removal. Discards pouch in a yellow plastic lined
trash can
9. Uses toilet tissues to remove excess stool from
the stoma
10.Covers stoma with a gauze pad
11.Applies skin barrier and appliance together by:
a. Selects size for stoma opening by using the
measurement guide
b. Traces same size circle on the back and center
of the skin barrier
c. Uses scissors to cut an opening ¼ - ⅛ inch
larger than stoma
d. Removes the back to expose sticky part
e. Removes gauze pad covering from stoma.
Sticks barrier and pouch over the stoma and
gently presses onto the peristomal skin for 1 – 3
minutes
12. Folds end of pouch bag upward and secure with
clamps/clips.
13. Disposes/cleanses used equipment in a yellow plastic lined
trash can. Removes gloves. Washes hands
14. Documents appearance of stoma , condition of peristomal
skin, characteristics of drainage (amount, color, consistency,
unusual odor), client’s reaction to the procedure
Video:
https://www.youtube.com/watch?v=h8CtsPAaa5Y
