Ostomy and Nursing care plan

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Objectives

•Define ostomy structure

•Enumerate indication of ostomy

•List some of ostomy types

• Recognize purpose of colostomy care

• Demonstrate the care of colostomy :

–Appliance

–Removal

–Evacuation

Ostomy

• Ostomy are performed when an infant or child requires fecal or urinary diversion.

•An adhesive appliance is usually applied just after surgery to measure drainage.

Indications for ostomy

Ostomy is done to some conditions such as:

– Imperforated anus

– Inflammatory bowel syndrome

– Trauma

– Tumor

– Hischsprung`s disease

– Spina bifida

Ostomy types

• ileostomy

• Colostomy

• Urinary diversion

Purpose of colostomy care

• In children and infants ,osteomies pose special problems because of fragility of the skin.

•Care must be taken to prevent skin breakdown at site.

1) Maintain integrity of stoma and periostomal skin

2) Prevent skin breakdown caused by fecal contamination

3) Prevent infection

4) Promote general comfort

5) Reduce odor from over use of old colostomy pouch

6) Asses stoma

Nursing Procedure in ostomy

Equipment:

Pouch and clamp

Stoma adhesive or other pectin wafer

Warm water and soap

Washcloths or gauze

Towel or gauze

Water proof pads

Disposable gloves

Graded container

Scissor and stoma measuring guide

Procedure:

1. Explain procedure to parents and older child

2. Perform hand washing

3. Provide privacy

4. Don gloves

5. Remove old pouch(using fingers to gently remove adhesive stoma)

6. Put pieces of gauze over stoma opening

7. measure the output using graded container to record it(open the clamp)

8. Discard the stoma continent in the toilet

9. Place pad on the bed to protect it

10. Wash the skin and stoma gently with water and soap

11. Dry area and note any skin breakdown

12. Measure stoma using measuring guide

13. Trace appropriate circle carefully on the back of stoma adhesive

14. Cut the circle with scissors

15. Remove the plastic cover

16. Center skin barrier over stoma ,adhesive side down and gently press it on skin

17. Gently press the pouch opening onto the ring until it snap in place

18. Close the opening of the pouch with clamp

19. Document the procedure in the chart.

Documentation

• Time and date

• Color, consistency and amount of feces in pouch

• Conditional of stoma and periostomal skin

• Size of stoma

• Abdominal assessment

• Emotional status

• Child \parents teaching points

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Posted in Nursing Care Plans, Nursing Intervention, Surgical and Medical

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