ostomy

Question 1

what are stoma care teaching points?

Answer 1

Stoma color – should appear beefy and red Stomal membrane: Should be shiny and moist

Protrusion – normal stoma will only protrude slightly; is it flush, retracted, or protruding significantly outward?

Stoma output (amount and type) – normal is anywhere between 500 – 1000 mL each day (depends on type of stoma/location of stoma)

Peristomal skin – assess for signs of infection, excoriation, redness, etc.

Stoma size

Don’t forget to assess PQRSTU & psychosocial and psychological wellbeing

Question 1

what nutritional teaching points for pt w ostomies?

Answer 1

Eat smaller more frequent meals throughout the day

Eat slowly and chew the food well

Drink 8 to 10 glasses of water each day

Avoid foods such as nuts, raw fruit skins, popcorn, and raison as they can potentially result in a blockage of the stoma

Avoid gas/odour producing foods (asparagus, broccoli, beer, alcohol, cabbage, corn, cauliflower, spicy foods, chewing gum, garlic, etc)

Question 2

what teaching should you give abt changing/emptying ostomies?

Answer 2

in the morning when the gut is the least actively

empty when 1/3 full

The wafer should fit snug around stoma, 1/8” close to stoma

Question 3

how do you prevent skin breakdowns w ostomies?

Answer 3

• Change appliance every 3 to 5 days
• Ensure right size of pouch/flange is used (too loose can
  cause irritation to surrounding skin)
• If there is burning or itching, the system needs to be
  changed
• Gently remove skin barrier from top to bottom – adhesive
  remover may help
• Clean peristomal skin with warm water
• Ensure soap is oil and residual free
• Ensure peristomal skin is dry
• Cover with a hydrocolloid wafer before applying the bag
• Apply skin barrier if needed
• Place a towel under stoma to prevent leakage onto healthy
  skin

Question 4

what are post op teaching points for ostomies?

Answer 4

• color
• consistency of stool
• how to mask odours
• signs of complications
• what the size should be
• when to empty
  -Swimming in water max 30-60 min, change apparatus and
  go back

Question 5

When to Seek Medical Attention (ostomy)?

Answer 5

Fluid and electrolyte imbalance
Fever
Diarrhea
Constipation
Change in stoma appearance
Change in stoma function
Change in peristomal skin