Are you interested in working in the field of colostomy nursing care? Perhaps you’ve been curious about what colostomy nursing care entails. Fear not, as your aspirations are about to be fulfilled. This article will define colostomy nursing care and explore various related topics.
Colostomy nursing care involves tending to the surgical wound created in the colon, known as a stoma, which protrudes through the abdominal wall. The procedure can be either permanent or temporary, depending on the underlying cause. After a colostomy, patients lose control over their bowel movements.
Patients utilize a pouching system attached to the stoma to collect waste products. Individuals with a colostomy require additional care to adjust to lifestyle changes, dietary considerations, habits, and sexual practices. Preparing patients for preoperative colostomy nursing care is essential for nurses, as it helps patients cope effectively after undergoing a colostomy procedure.
Conditions that may necessitate a colostomy include:
– Cancer of the anus, colon, or rectum
– Crohn’s disease
– Bowel obstructions
– Ulcerative colitis
Ileostomy vs. Colostomy Nursing Care
Many nursing students often confuse these two terms. An ileostomy involves creating an opening in the ileum to treat conditions such as ulcerative colitis and divert the contents in cases of colon cancer, trauma, or polyps. Ileostomy nursing care is necessary when the colon, anus, and rectum have been removed.
Colostomy nursing care, on the other hand, involves diverting the effluent from the colon either permanently or temporarily. A stoma is formed to collect waste generated from the body’s metabolic processes.
Colostomy Nursing Care Plan
As a nurse, your role is to assist patients who have undergone colostomy surgery and provide them with the necessary education to prevent complications. When caring for a patient who has undergone colostomy surgery, it is important to advise them to:
– Inspect the stoma and the surrounding area:
Show patients how to assess redness, rashes, bleeding, and measure the protrusion or retraction of the stoma. This is particularly important during the initial weeks after colostomy surgery.
– Assess their diet:
In the first few months after surgery, patients should monitor their food intake to avoid causing diarrhea or excessive waste production, which can lead to skin irritation.
– Be aware of any allergies:
Check for allergies to barrier paste, adhesives, or pouching systems. Sensitivities can develop even after prolonged use of a product.
Post-operative Nursing Care for Colostomy
– Keep the area dry and clean:
Prevent stool from coming into contact with the skin around the stoma. Use a washcloth and warm water or toilet paper to clean the site. Avoid using detergents and ensure the area is completely dry before applying adhesives.
– Apply a protective paste:
Patients can apply a protective paste or powder to facilitate proper adhesion of the skin barrier and prevent leaks.
– Measure the wafer:
Wafers or skin barriers secure the pouch to the skin. It is important to measure the wafer correctly to ensure it fits the stoma appropriately. The diameter of the wafer should be between 1/16 and 1/8 of the stoma’s size.
– Educate the patient about the pouching system:
Inform patients that pouches should not be replaced too frequently, as it can irritate the skin. Several days should pass before changing the pouch. Teach patients to avoid pulling on the skin when removing the pouch.
– Encourage confidence:
Patients may feel apprehensive about managing colostomy care. Encourage their confidence by involving them in the care process and providing positive reinforcement.
Assisting Patients with Colostomy-Related Issues
After colostomy surgery, patients may experience excessive gas. This is a common and harmless symptom following abdominal surgeries. To minimize noise, patients can gently cross their arms over the stoma when they feel the need to burp. Certain medications can help alleviate gas. It is important to avoid foods that can cause gas, such as eggs, broccoli, cabbage, onions, cheese, fish, milk, beans, carbonated beverages, and alcohol.
Odor can be caused by specific foods, normal intestinal flora, medications, or vitamins. Patients should choose pouching systems that resist odors, ensure the skin barrier adheres firmly to the skin, and regularly empty the pouch. Adding antiperspirant tablets or liquids to the pouch can also help control odor. Medications like chlorophyll pills or bismuth can be beneficial. Sanitizing wipes can be used to limit odor when draining the pouch.
– Skin problems:
Large, red, painful, or weeping areas of the skin around the stoma can prevent a tight seal. It is important to address mild irritations promptly. Consult a physician or ostomy caregiver if there is a large inflamed area or if the condition worsens despite treatment. Prescription medications may be recommended for oral or topical use to aid in skin healing and drying. If an extremely tight ostomy belt causes deep pressure sores, it is crucial to relax or remove the belt and seek immediate medical attention.
Temporary lack of output from the stoma is normal, but if a patient experiences cramping, pain, nausea, and the stoma remains inactive for 4 to 6 hours, it may indicate an obstruction. Patients should contact their doctor or ostomy nurse in such cases. To facilitate movement through the stoma, patients can monitor stoma size and adjust the wafer’s aperture accordingly, engage in a warm bath, consume fluids instead of solid foods, and change positions to stimulate bowel movement. Laxatives should be avoided. If discomfort persists and the patient cannot reach their doctor or ostomy nurse, immediate medical attention should be sought.
Diarrhea is a sign that something is amiss. It is characterized by more frequent, looser, or liquid bowel movements than normal. Diarrhea can be caused by various factors, including food poisoning, stomach infections, certain medications, or even partial obstruction. Patients experiencing persistent diarrhea should consult their colostomy nursing care provider and provide details about their diet, feeding schedule, and any medications they are taking. Prompt medical assistance should be provided.
– Phantom rectum:
Some patients may experience the sensation of needing to urinate even after the rectum has been removed. This feeling can persist for years after surgery and may occur at any time. Patients may also pass mucus while using the restroom. Sitting on the toilet and simulating a bowel movement may provide relief.
When Should a Colostomy Patient Seek Medical Attention?
Patients with a colostomy should consult a doctor or seek medical attention if they experience:
– Cramping lasting more than 2 hours
– Continuous vomiting and bleeding
– No output from the stoma for 5 to 6 hours
– Severe watery discharge
– Cuts or injuries to the stoma
– Foul odor
– Deep sores or skin irritation
– Bleeding where the stoma meets the skin
– Unusual observations around the stoma
– Changes in stoma color or size
In conclusion, colostomy nursing care is crucial for patients who have undergone colon surgery, resulting in a stoma. Various conditions, such as cancer of the rectum or intestines, may necessitate this surgical intervention. As a nurse, you play a vital role in assisting patients with post-operative care, educating them about their colostomy, and helping them manage related challenges. If you are a student studying colostomy nursing care and need assistance with assignments, consider reaching out to Customnursingessays.com, where expert nursing essay writers can help you achieve your desired grades in all your nursing papers.