Ostomy Care and Management Flashcards
Why do we irrigate a colostomy?
Allows client to schedule when they have bowel movements
What is an ostomy?
A surgically artificial excretory opening
Named relative to their anatomical location in the bowel
How are bowel ostomies classified?
According to their status as permanent or temporary
Anatomical location the name of the construction of the stoma
Temporary or permanent colostomies?
Temporary:
-generally performed for traumatic injuries or inflammatory conditions of the bowel
Permanent:
-performed to provide a means of elimination when the rectum or anus is nonfunctional as a result of a birth defect or a disease
Ileostomy?
Generally empties from distal end of small intestine
Produces liquid decal drainage
-contains digestive enzymes, less odour because fewer bacteria are present
Unregulated
Ascending colostomy?
Decal drainage is liquid
- contains digestive enzymes
- odour is a problem
Unregulated
Transverse colostomy?
Produces malodorous, mushy drainage because some liquid has been absorbed
Unregulated
Descending colostomy?
Solid fecal drainage m
Stool from sigmoidostomy is of normal or firmed consistency
Frequency of discharge can be regulated and odours can be controlled
What is within the LPN scope around colostomys?
LPNs can irrigate them
Change the collecting bag and clean them
Assessments
LPNs must have competence around doing the skill
Never put anything into a stoma
What are some illness/conditions which would indicate creator of a colostomy?
Crohns Colon cancer Ulcerative colitis Bowel obstruction Trauma Genetic condition
What type of ostomy does patients with crohns and ulcerative colitis have?
Crohns: colostomy or ileostomy
Ulcerative colitis: ileostomy
Characteristics of healthy newly established stoma?
Red in color Swelling/edema up to 6 weeks Mild/moderate bleeding in stoma and mucosa junction Warm May not be active Pain Peri-stomal skin intact
What to report about newly formed stoma?
Excessive bleeding
Pale or blue in color
Increased amount of pain
Focused assessments for post op client with newly formed ostomy?!
ABCs Pain/sedation Abdominal assessment Incisions/drains Assessment of stoma I&O Signs of infection/thrombus Safety Neurological Fecal assessment
Possible complications of GI surgery?
PE Paralytic ileus Bleeding Invertion of stoma Protrusion of stoma Peritonitis Pain
