Colostomy: Is an opening surgically created from the
ascending, transverse, or descending colon to the
abdominal wall.
Ileostomy: Is an opening surgically created from the
ileum to the abdominal wall.
Large intestine:
Small intestine:
Purposes:
1. To discharge waste (liquids, solids, and gases ) to the
outside of the body.
2. To improve survival and the quality of life for the
patient.
Assessment:
1. Inspect the stoma for color and texture.
2. Inspect the condition of the skin surrounding the
stoma.
Equipment needed:
1. Clean washcloth or 4×4 gauze pads.
2. Warm tap water.
3. Scissors.
4. Pen or pencil.
5. Clean gloves.
6. Appropriate drainable ostomy appliance includes:
A. Ostomy skin barriers, also called wafers.
B. Ostomy drainage bags, also called pouch.
7. Measuring guide
Patient education needed:
1. Instruct the patient on pouch application, including
frequency of change.
Most pouching systems can be maintained for a
minimum of 3 days to a maximum of 7 days.
2. Instruct patient on changes in skin condition to report
ostomy care to nurse.
3. Provide the patient with a list of equipment and
retailers where supplies can be purchased.
4. Provide the patient with a list of reasons and
situations on when to call the health care provider.
Nursing implementation:
1. Removing old appliance
2. Assessment
3. Applying the new appliance
Identify the patient and explain procedure to the
patient.
Provide for patient`s privacy.
Wash hands/ apply gloves.
Maintain body mechanics.
Assemble drainable pouch and wafer.(equipment)
Remove current ostomy appliance after emptying
pouch of stool, if present.
Dispose of appliance in appropriate waste container.
Remove gloves and wash hands.
Apply clean gloves.
Cleanse stoma, skin with warm water and pat dry.
Measure stoma using a measuring guide for
appropriate length and width at base ( where skin meets
stoma ).
Place gauze pad over orifice of stoma to absorb stool while
the wafer and pouch are being prepared for application.
Trace pattern onto paper backing of wafer .
Rational: It is important to trace the measurement of the
stoma and avoid " eye ball " measurement. Incorrect pattern
size results in either laceration of the stoma by the wafer or
maceration of peristomal skin from constant contact with
stool.
Cut wafer as traced.
Attach clean pouch to wafer and make sure port
closure is closed.
Remove gauze pad from orifice of stoma.
Remove paper backing from wafer and place the
wafer and pouch on skin with the stoma centered in the
cutout opening of the wafer.
Tap the wafer edges down with hypoallergenic tap
(optional).
Remove gloves and wash hands.
Document the procedure.
Thank you
****
