UNIT 8 COLOSTOMY CARE & COLOSTOMY MANAGEMENT CHAPTER 51

Question 1

Assessment of Colostomy

Answer 1

Assess gastrointestinal status, including:
* Dietary and fluid intake and habits
* Presence or absence of nausea and vomiting
* Weight gain or loss
* Bowel elimination pa ern and characteristics and amount of effluent
stool
* Bowel sounds
Assess condition of stoma at least weekly, including:
* Location, size, protrusion, color, and integrity (check for stoma retraction,
prolapse or stenosis)
* Presence of peristomal hernia
* Signs of ischemia, such as dull coloring or dark or purplish bruising Assess peristomal skin for:
* Presence or absence of excoriated skin, leakage underneath drainage system
* Presence of folliculitis (inflammation of hair follicles) or dermatitis (inflammation of skin)
* Fit of appliance and effectiveness of skin barrier and appliance Assess the patient’s and family’s coping skills, including:
* Self-care abilities in the home
* Acknowledgment of changes in body image and function
* Sense of loss

Question 2

PT with Ileostomy

Answer 2

 Stoma should be pink to cherry red
 Pt must wear pouch at all times
 Skin care around stoma is a priority!
 Skin protection:
 Skin barrier to protect skin from stool
 Watch for redness/irritation

 Pouch Care:
 Empty when 1/3 to ½ full, change entire pouch Q3-7 days
 Nutrition:
 Chew food thoroughly, be cautious with high fiber foods(to avoid gas In colostomy bag)
 Drug Therapy:
 No enteric coated meds, no laxatives or enemas
 Symptoms to watch???