Posted: January 21st, 2023

What is colostomy nursing care?

Are you willing to work in the colostomy nursing care unit? Do you keep wondering what colostomy nursing care is? Worry not, as your dream is about to come true. This article defines colostomy nursing care and explains several related topics.

Colostomy nursing care is taking care of the wound of a surgical procedure of the colon through the abdominal wall, referred to as the stoma. The procedure may be permanent or temporary, depending on the cause of the surgery. After colostomy, patients lose control of their bowel movements.

Patients wear a pouch system in the stoma to help collect waste products. People with colostomy need extra care to adapt to lifestyle changes, diet, habits, and sexual lifestyles. Preparing a patient for preoperative nursing care for colostomy is important for a nurse. This is to help in coping well after undergoing a colostomy procedure.

Conditions that may lead to a colostomy

• Cancer of the anus, colon, or rectum
• Diverticulitis
• Crohn’s disease
• Bowel obstructions
• Ulcerative colitis

Ileostomy versus colostomy nursing care

Many nursing students confuse the two terms. An ileostomy is an opening in the ileum that treats ulcerative colitis and diverts the contents in the cancer of the colon, trauma, and polyps. Ileostomy nursing care comes in while the colon, anus, and rectum are removed.

Colostomy nursing care involves permanently or temporarily diverting the colon’s effluent. A stoma is formed that collects all waste from the body’s metabolism.

Colostomy nursing care plan

As a nurse, you must assist patients undergoing colostomy surgery and provide them with the necessary education to prevent complications. Whenever you have a patient who has undergone colostomy surgery, advise the patient to do the following;

1. Inspect the stoma and the surrounding area

You should show the patient how to assess the redness, rashes, and bleeding to ensure they measure the redness and monitor any retraction or protruding. This is essential in the first weeks of colostomy surgery.

2. Assessing the diet

For the first few months after surgery, advise a patient to assess their food. The food a patient is eating should not cause diarrhea or a lot of waste products leading to skin irritation.

3. Assessing any allergies

Check for barrier paste, adhesion, or pouch system allergy. After using a product for weeks, months, or years, sensitivities might still arise.

Post-operative nursing care for colostomy

1. Keep dry and clean

Keep stool away from the area around the stoma. Use a washcloth and warm water or a piece of toilet paper to wash the site. Usually, detergent is not advised. Before using adhesives, ensure that the area is fully dry.

2. Applying a protective paste

You can advise a patient to apply a protective paste or powder to help fit an adhesive into the skin to prevent any leakages.

3. Measuring the wafer

The pouch is fastened to the skin by the wafers or skin barrier. Wafers must be appropriately measured to ensure that they do not tightly or loosely fit the stoma. To do this, measure the stoma and cut the wafer so that the diameter is between 1/16 and 1/8 of the stomas.

4. Educate the patient on the pouch system

Make sure the patient knows that replacing the pouch frequently irritates the skin. Several days should pass before doing this. Teach them not to tug on the skin when extracting the pocket.

5. Encourage a patient to be confident

Patients could feel uneasy handling colostomy nursing care. Encourage confidence by involving them in caring and giving them encouraging remarks.

Helping patients manage colostomy-related problems

1. Gas

After undergoing colostomy surgery, you may feel like you have a lot of gas. This unsettling, unpleasant, innocuous symptom follows most abdominal surgeries. Stomach grumbling or gassy sounds may be cause for concern. Say, “Sorry me, my stomach is grumbling,” if you are worried that adjacent people will overhear you.

When you sense that you may be about to burp in front of others, gently cross your arms such that your elbow lies over your stoma. This will muffle most sounds. Ask your colostomy nursing caregiver what medications you can use to help with gas. Eggs, broccoli, cabbage, onions, cheese, fish, milk, beans, carbonated beverages, and alcohol are just a few of the items that can give you gas.

• Frequent eating will aid in preventing gas
• Eat smaller meals four to five times per day
• AVOID skipping meals to prevent gas or bloating

2. Odor

Various things can bring odors, including specific foods, the usual flora in your intestines, certain medications, and vitamins. Eggs, broccoli, cheese, cucumbers, onion, fish, garlic, dairy products, and coffee are some foods that might emit an odor. Avoid processed foods that make you uncomfortable if you can.

• Use a pouch that resists odors
• Verify that the skin barrier adheres to your skin firmly
• Frequently empty the pouch.
• Put certain antiperspirant tablets or liquids in the pouch

You can take various medications that might be helpful. Talk to your physician or the ostomy nurse to learn more about these medications and how to use them. Chlorophyll pills, bismuth, and bismuth subcarbonate are a few items that many individuals have discovered helpful with odor. When draining the pouch, keeping air sanitizing wipes in that space can help effectively limit the stench.

3. Skin related problems

You won’t be able to achieve a tight seal across your stoma if you have large, red, painful, and weeping (consistently moist) regions of your skin. It’s crucial to treat mild irritations as soon as possible. Consult your physician or an ostomy caregiver if there is a large inflamed area or one that is growing despite particular treatment.

To assist your skin drying out and recovery, they may prescribe drugs for oral use or to apply topically to your ostomy. When an extremely tight ostomy belt is the source of deep pressure sores, relax or disconnect the strap and immediately contact your doctor or an ostomy nurse. You’ll require medical care

4. Obstruction

Your ostomy may occasionally go without output for a brief length of time. That is typical. However, if you experience cramping, pain, or nausea and your stoma becomes inactive for 4 to 6 hours, the intestines may be obstructed. If this occurs, contact your doctor or the ostomy nurse right soon. You can perform the following to aid in the movement of objects through your ostomy:

Keep an eye out for stoma enlargement and modify the wafer’s aperture as necessary until the swelling subsides.

• To soothe your stomach muscles, engage in a warm bath
• Taking fluids is advised if there is bowel output: Avoid eating solid foods
• The food in your gut may occasionally move more quickly if you alter your position, for as by bringing your legs up to your chest
• Don’t use laxatives

Obstacles may result from fiber-rich foods like corn, pineapple, almonds, cabbage, celery, and greens. Internal modifications, such as adhesions, might also result in obstruction. Go to the emergency hospital if you continue to experience discomfort and cramps with no production from the stoma for more than two hours and you cannot call your doctor or ostomy nurse. Bring all of your ostomy supplies along.

5. Diarrhea

Diarrhea is an indication that something is not ok. It is categorized by more regular, looser, or liquid bowel movements than normal. Food passes through the intestinal tract too rapidly to absorb water and minerals. This could cause unexpected pain. Your body could lose a significant amount of water and minerals. If you lose these minerals, you should replace them immediately to prevent illness caused by dehydration.

Diarrhea can be caused by many factors, such as; food intoxication or stomach infection, which may also result in temperature rise and vomiting. Antibiotics, and other prescribed drugs, may also cause diarrhea. Partial impediment may also bring a smelling discharge, strong liquid output, pains, and stoma noises, which may cause diarrhea.

If you experience obstinate diarrhea, consult your colostomy nursing care provider. Let them know your daily diet, feeding schedule, and any medicines you take. As a nurse, provide the right medical assistance to the patients.

6. Fictitious rectum

The phantom rectum is similar to the “phantom limb” experienced by amputees who believe their missing leg is still present. You should experience the same need to urinate that you had before surgery. This can occur at any moment and may persist for many years following surgery. You could have this sensation in addition to passing mucus while using the restroom if the scrotal sac has not been evacuated. After removing their rectum, some patients claim that staying on the toilet and pretending to have a bowel movement helps them feel better.

When should a colostomy patient see a doctor?

• If cramping extends for more than 2 hours
• If you have continuous vomiting and bleeding
• If you have no ostomy for 5 to 6 hours
• If you see a severe watery discharge lasting for long
• If you see a cut in the stoma
• If you experience a foul odor
• If you notice any injury in the stoma
• If you get deep sores or skin irritation
• Bleeding where stoma meets the skin
• Any unusual thing around the stoma
• Change in the stoma color or size

To sum up

Colostomy nursing care is crucial for patients who have undergone colon surgery where a part of the large intestines is cut, leading to an opening at their stomach known as a stoma. Several conditions, such as cancer of the rectum or intestines, may lead to the surgery.

As a nurse, you should help patients who have undergone such surgeries by showing them how to assess the stoma, check the diet and assess any allergies that might occur. Help the patients through colostomy-related problems such as odor, gas, fictious rectum, and obstruction.

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