colostomy care.

by:Yucai     2020-05-16
The placement of the colon stoma is usually due to complications associated with trauma, infection, cancer, congenital abnormalities and inflammatory diseases (
Walker, Lao and green, 2015).
It can be permanent or temporary.
The acceptance of colostomation requires not only physical but also psychological adjustments to patients and their caregivers.
The average patient who underwent surgery was hospitalized for 5 days.
The shortened stay time limits the educational time.
Because the average complication of mouth surgery is 24%.
59%. Education must be consistent throughout the stay in hospital to reduce complications and re-admission.
Patient education is one of the most important roles of registered nurses for related patients.
This is an ongoing process that starts with the first patient interaction and continues throughout the hospital stay.
Walker and his colleagues suggested that nurses who often provide effective education can identify problems related to Colon stoma care as early as possible, so that patient success can be obtained through a professional-to-professional approach before discharge.
The basic knowledge of the education of the patient and the nursing staff of the colon is essential to ensure appropriate mouth care.
Before providing education, the nurse should ensure that the patient is comfortable with minimal pain or discomfort.
Patients with pain will not attend educational meetings.
So pain must be goodmanaged.
It is also important to assess the manual flexibility of patients and caregivers.
Because colon mouth care involves manipulation of supplies, nurses should ensure that patients and caregivers can manipulate them without difficulty.
Limited time during hospital stay, several key parts of education must be addressed (Kirkland-
Kyhn, Martin, Zaratriewicz, Whitmore, Young, 2018)
It includes replacing the pou mouth system, emptying the appliance, planning enough nutrition and avoiding complications.
Patients and caregivers should use as much as possible the colon-made device and actively participate in the replacement and emptying of the suction system.
Patients can use two pou bag systems for mouth making: Onepiece and two-piece systems. A one-
Wafer system (
Skin barrier attached to the skin)
Connected with electrical appliances. The two-
The Piece system has a device that captures the chip separately.
At the end of any device will be a turn off.
This closing or clamping will fix the device or the device will be automatically sealed (Kirkland-Kyhn et al. , 2018).
At some point in the day, bowel activity slows down.
The filling system should be changed during that time.
The morning before the patient eats or drinks is the best time.
The system can also be changed 1 hour after the meal is completed (
Cancer Society of AmericaACS], 2017).
When the patient is ready to replace the eye bag, all supplies should be ready.
Once the supplies are ready, the patient should be taught to measure the mouth.
After the operation of the mouth, with the decrease of swelling, the size of the mouth will decrease.
The swelling is usually 6-
8 weeks after surgery (Prinz et al. , 2015).
Only 1/8 of the skin around the mouth is visible to prevent skin irritation and rupture (Schryber, 2016).
Next, the mouth should be thoroughly cleaned (Prinz et al. , 2015).
To avoid changes in the pH of the skin, patients should be taught to avoid using soap in this area (Schryber, 2016).
Patients should also be told that the use of any moisturizer in this area may affect the adhesion of the pou tube system.
At this time, check for any wounds, rashes or damage to the mouth and surrounding skin.
Usually apply peripheral skin protection in the form of a paste or barrier ring.
Then connect the wafer and the device.
While preventing leakage, pressing the wafer in place will ensure adequate sealing.
Patients should make sure the end of the appliance is closed according to the Poching system.
Filling System every 3-replacement
7 days or a leak (Prinz et al. , 2015).
The presence of oily skin, sweating, and physical activity may increase the frequency of changes to the pou mouth system (ACS, 2017).
Empty bag colon pocket should be emptied at 1/3-1/2 full.
Allow the bag to fill more than this quantity and it will become very heavy.
Heavy bags are easier to leak.
Bags should also be emptied before going to bed (Schryber, 2016).
During the stay in hospital, before the colon stoma is emptied, there should be a cylinder device for collecting feces, a barrier pad for protecting the skin/clothes, and tissue wiping.
The patient shall remove the clip at the end of the pocket making and discharge the contents into the cylinder device, and then wipe the end of the appliance and clip with a paper towel to ensure that any feces are removed.
The clip should be securely attached to the end of the device.
When emptying the cylinder, the patient should be taught to pay attention to any signs of blood or foul
Smell in the output (Prinz et al. , 2015).
After the patient moves, it can be done on the toilet, but the contents should be gently released on the toilet to prevent splashing (ACS, 2017).
Nutrition after surgery, patients will advance to lowfiber, low-residue diet.
They will be pushed to a regular diet.
8 weeks after surgery
Patients with colon stoma should eat well-
A balanced diet and plenty of water.
Should not eat.
Follow the general principles of nutrition to prevent water and gas (Kirkland-Kyhn et al. , 2018).
Patients should also be made aware of foods that will increase gas, smell and blockage.
Onions, broccoli, carbonated drinks and alcohol produce gas. Odor-
The food produced includes onions, asparagus, eggs and fish.
The consumption of corn, celery, cabbage, nuts, popcorn and seeds can cause the mouth to be blocked (Schryber, 2016).
Complications for new mouth patients, one of the main concerns is the complications associated with the new mouth site.
Because this indicates sufficient perfusion, the color should always be strong red.
Dark red, blue or black indicates necrosis.
The development of linear discoloration in crimson, white or yellow indicates trauma.
Any color other than strong red is an emergency.
Other issues that should be immediately reported to the provider include separation from the surrounding skin, prothesis, bleeding from the surrounding area, change in length, reduction of lumens (Prinz et al. , 2015).
The output position of the mouth-making technique will determine the consistency of the feces to be produced.
If there is no feces output in 4-
For 6 hours related to cramps and nausea, the doctor should be informed that there may be a blockage.
Unpleasant smells lasting more than a week usually indicate infection.
The intake of food, antibiotics, or other drugs can cause loose stools.
Raw vegetables, juice, milk and Western plum juice are examples of foods that can change the consistency of stool (ACS, 2017).
However, this change should only last for a very short time.
Diarrhea more than 5 stools if water-
6 hours, the patient should inform the doctor.
Diarrhea causes electrolyte imbalance.
According to the patient\'s medical history, electrolyte imbalance can lead to other systemic problems (Prinz et al. , 2015).
Conclusion The placement of the colon stoma needs to be greatly adjusted for patients and their nursing staff.
The foundation of oral care is education.
This helps to ensure that they understand the basics of the care of the colon stoma and what complications should be reported.
Providing early education gives patients and caregivers an opportunity to learn, practice and retain information so that complications can be avoided.
Even after discharge, as patients and their caregivers become more independent with respect to the care of the colon, they use this information (Rupp, 2015).
Cancer Society of America (ACS). (2017).
Take care of the colon.
From Kirkland-Kyhn, H. , Martin, S.
Zaratriewicz, S. , Whitmore, M. , & Young, H. (2018).
Mouth care at home
Journal of American Nursing, 118 (4), 63-68. doi:10. 1097/01. NAJ. 0000532079. 49501. ce Prinz, A. , Colwell, J. C. , Cross, H. H. , Mantel, J. , Perkins, J. , & Walker, C. A. (2015).
Discharge planning for new mouth patients: Best practice for clinicians.
Journal of wound mouth control nursing, 42 (1), 79-82. doi:10. 1097/WON.
00000 rupees 00000000094. (2015).
Skills to help nurses improve patient education skills.
Retrieve from M. SchreiberL. (2016).
Care and Management.
Nursing, 25 years old (2), 127-131. Walker, C. A. , Rau, L. A. , & Green, M. P. (2015).
A new patient is welcome home.
Family Health is now 33 years old (7), 385389. doi:10. 1097/NHH.
000000000000259 Sonya Blevins, DNP, RN, CMSRN [R]
CNE is the clinical College of New Hampshire University in southern United States, Graduate Program, Manchester, NH.
Custom message