National institute of Nursing Education, PGIMER, Chandigarh

TOPIC: CLINICAL TEACHING ON COLOSTOMY CARE

SUBMITTED TO: SUBMITTED BY:

Mrs. Rupinder Kaur Richa Mishra

Nursing Tutor M.Sc. Nursing 1st year

NINE,PGIMER NINE,PGIMER
LESSON PLAN
SUBJECT: Child Health Nursing

TOPIC: Colostomy Care

GROUP OF STUDENTS: MSc. nursing 1st yr students

NO. OF STUDENTS: 05

STUDENT TEACHER: Richa Mishra

METHOD OF TEACHING: Lecture cum discussion

DATE OF TEACHING: /10/23

DURATION: 25min

VENUE: Advance Pediatric Centre

TEACHING AID: Demonstration

SUPERVISOR: Mrs. Rupinder Kaur

PREVIOUS KNOWLEDGE Students have little knowledge about colostomy care

LEARNING OBJECTIVES:

 General Objective:

At the end of the class, students will be able to provide colostomy care to the patients.

 Specific Objective:

At the end of class, students will be able to:

1. Define colostomy care

2. List down the indications for colostomy care
3. Enlist the purposes of colostomy care
4. Perfom colostomy care skillfully and effectively
5. Mention special Consideration while providing colostomy.
S No. Contributory Time Content matter Teaching learning activity
objectives Method AV aid Evaluation
1 Student teacher 20sec Self-Introduction: I am Richa Mishra, student of M.Sc. nursing 1st
will be able to year.Today I am going to demonstrate colostomy care.
establish rapport
with the group

2 Appraise the topic 10sec Today’s topic is colostomy care

The topic will cover-
 Definition
 Indications
 Purposes
 Steps of procedure
 Summary
 Conclusion

3 Recall of 30sec Review of previous knowledge

Previous What do you understand with colostomy care?
knowledge How tp provide colostomy care?
What Could be the reason to provide the colostomy care?

4 Definition of 2min Definition:- Colostomy refers to a surgical procedure where a portion of the Lecture Define
colostomy care large intestine is brought through the abdominal wall through which stool is cum colostomy
be excreted. The surface of the stoma is actually the lining of the intestine, discussion care
usually appearing moist and pink. “Colostomy care refers to the procedure of
cleaning the stoma intermittently along with the surroundings skin in order to
keep it clean,healthy and functional”
S No. Contributory Time Content matter Teaching learning activity
objectives Method AV aid Evaluation
5 List down the 3min Indications for colostomy care:- Lecture What are
indication for cum the
colostomy care Children may are quite colostomy for various health problems like discussion indications
for
 Imperforate anus in infants. providing
 Hirschsprung's disease. colostomy
 Necrotizing enterocolitis. care?
 To prevent excoriation of skin and stoma.
 To teach patient and relatives about care of the colostomy

6 Enlist the purpose of 2min Purposes of colostomy care:- Lecture State some
colostomy care cum purposes
 To prevent leakage. discussion for
 To observe stoma and surrounding skin. colostomy
 To prevent excoriation of skin and stoma care?
 To teach patient and relatives about care of the colostomy.

7 Perform colostomy 2min Steps of Colostomy care Lecture Demonstr Demonstrat

care skillfully and cum ation e the steps
effectively 1. Article Required discussion of
colostomy
 Warm water in a bowl. care.
 Cotton swabs: Dry and wet.
 Vaseline/coconut oil/zinc oxide ointment or any prescribed ointment.
 4"-6" wide 50 cm long soft clean cloth (colostomy bag homemade) with
four stings at four corners to tie around the abdomen. Cut 3" x 3" pieces
of a soft cloth and soak them in coconut oil or Vaseline gauze
S No. Contributory Time Content matter Teaching learning activity
objectives Method AV aid Evaluation

 Cotton dressing/small cloth pieces/napkins for soaking the stool from

colostomy.
 A big size bag made of waste paper to discard the soiled dressing.
 Clean gloves to prevent infection.
 Adhesive and scissors.
 Kidney tray to collect waste.
 Mackintosh/rubber sheet and draw sheet to prevent soiling of bed sheet
and baby's cloths.

8 2min Pre-procedural Steps:- Lecture Demonstr

cum ation
 Assemble all the articles required for colostomy care at bedside of the discussion
child. It ensures that you have everything necessary to render colostomy
care. Ensure that you have all the materials that you need based on the
type of colostomy your patient has.
 Provide privacy by using screen as child may be uncomfortable to
exposure.
 Explain about the purpose of the procedure to the child if he/she can
understand and to the parents to gain their confidence and this brings
into light, concerning things that your patients may have. Remain
factual and answer all their queries with prompt and direct answers.
Guide them throughout the procedure especially if they will have
permanent stomas.
 Wash hands with soap and water to prevent infection.
S No. Contributory Time Content matter Teaching learning activity
objectives Method AV aid Evaluation

9 6min Intra-procedural Step:- Lecture Demonstr

cum ation
 Put the clean gloves discussion
 Ask the caregiver to lift the child with both hands little upwards and
spread mackintosh with draw sheet under the abdomen and hips of the
child. Put the child on draw sheet it will protect clothes from spoiling.
 Remove the soiled dressing gently and discard into a bag to receive
waste/kidney basin.
 Inspet the colostomy and determine the need to change of colostomy bag.
Inspection will allow you to make a judgement. You may change the
colostomy pouch if it is one third full of more frequently if the patient
desire.
 Note for any leakage,avoid changing colostomy during meal time ,before
and after meal time or during visiting hours.
 Remove gloves.
 Wash hand or use handrub to clean your hand to prevent infection.
 Take the saline swab, squeeze it and clean the stoma opening (one
swab,one stroke manner)Discard the swab into kidney tray.
 Take another saline swab and clean the colostomy (surrounding t g the
stoma) skin. Use separate swabs to clean both the sides around the
colostomy Clean with dry swabs, once it is completely dry leave it.
Promote hygiene and comfort for the patient. Use the tissue to remove
excess stool When cleaning the stoma, use warm water and clean wash
clothe. The use of strong soap is discouraged as they promote dryness
and are irritating to stoma. If you use soap, however,avoid moisturizing
soap as they interfere with the adhesiveness of the new skin barrier that
is to be applied. Dry the area by patting not rubbing.
S No. Contributory Time Content matter Teaching learning activity
objectives Method AV aid Evaluation

 If any ointment is prescribed apply around the stoma.

 Cover the colostomy with a piece of Vaseline gauze pad or piece dipped
in coconut oil. Cotton should be used for newborn during first few days
because their skin is very delicate.
 Put another piece of cotton on the vaseline/ coconut gauze.
 Support the dressing by tying the long cloth bandage around the baby's
tunumy.
 Wash your hands thoroughly
 The skin around the stoma should be cleaned every time the dressing is
changed

10 2min Post-procedural Steps:- Lecture Demonstr

cum ation
 Make the child comfortable discussion
 Discard the soiled dressing and the used swabs in the yellow dustbin
 Clean the articles and replace in the utility room. Wash hands
 Restore or terminate all articles appropriately for next use.
 After discarding waste wash hands thoroughly to prevent infection.

11 Mention special 3min Report immediately if: Lecture

consideration cum
 Non passage of fecal content/stool from last 48 hours. discussion
while providing
 Excessive or watery stool.
colostomy care  Excessive bleeding.
 Stoma size increases or decreases.
 Abdominal distension/regurgitation.
S No. Contributory Time Content matter Teaching learning activity
objectives Method AV aid Evaluation
 Foul smelling stool.
 The skin around the colostomy is constantly in touch with intestinal
juices which causes excoriation. Application of siloderm ointment
protects the skin from excoriation caused by intestinal juices and injury.
The skin around the colostomy should be cleaned every time the dressing
is changed.
 Note for any leakage. Avoid changing colostomies during meal times,
before and after meal times, or during visiting hours. The use of 'strong
soaps is discouraged as they promote dryness and are irritating to the
stoma. If you use soap, however, avoid moisturizing soaps as they
interfere with the adhesiveness of the new skin barrier that is to be
applied. Dry the area by patting, not by rubbing as it causes abrasions.

If any of the following complications occurs, report immediately to

doctor:

 Stoma retraction.
 Peristomal hernia, prolapse, stomal stenosis.

12 Summary 1min Summary:- In this topic we have discussed about colostomy care under Lecture
following point:- cum
discussion
 Definition
 Indications
 Purpose
 Steps Of procedure
 Special consideration

13 Conclusion 2 min Conclusion:-

S No. Contributory Time Content matter Teaching learning activity
objectives Method AV aid Evaluation

Colostomy care, as the name suggests, is an all-encompassing term referring

to colostomy management, from its creation to peristomal skin management,
to colostomy appliance application and mental health management while
dealing with a colostomy. The purpose of colostomy care is for skin
protection and care for patient acceptance and to prevent stoma related
complications. This activity outlines colostomy creation and care and
highlights the role of the inter professional team in evaluating and treating
patients with this condition.nclusion-

References:-

 Ghai Sandhya, Clinical Nursing Procedure Edition 2nd CBS Publishers

and distributors Pvt Ltd. New Delhi(2020) pp 989-992
 Perry AG,Potter PA.Nursing skills and procedure ,7th edition Publication
Elsevier. New-Delhi
 www.wikipedia