COLOSTOMY
Definition:- Artificial opening of the colon (large intestine) through the anterior abdominal wall.
Purpose:- escape the flatus and stool.
Indication:-
1.Intestinal Obstruction.
2.Rectal Tumor and cancer.
3.Intestinal Cancer.
4. Imperforate of anus
Classification:-
According to Placement:-
1.Wet Colostomy
2.Dry Colostomy
Wet Colostomy:-
- stool is passed out in liquid form by the client.
- Incision is making in ascending colon.
- ascending wet colostomy is performing for short term/Temporary.
- Time:- 6-8 weeks.
- Opening :-opening of colostomy on the right side of abdomen .
Dry Colostomy.
- Incision is making in sigmoid colon.
- Stool is passing out in normal form.
- sigmoid colostomy is performing for long time or permanent based.
- Opening:- end colostomy or left side of abdominal.
Procedure:-
- nurse role before procedure precaution.
- stop the high fiber diet before 2-3 day from procedure.
- doctor explain procedure.
- doctor collect consent.
- collect investigation and report of patient.
- NBM 8-12 hours before colostomy to prevent risk of aspiration.
- prepare part.
- best time for part preparation(before 30 minute form the surgery)
- Site prepare:- just below the nipple to mid thigh.
- Solution:- 7.5% betadine or 7.5% savlon.
Position:-
- 1.Supine position:-during general anesthesia use in surgery
- 2. Trendelenburg:-when spinal anesthesia use during surgery.
Care of colostomy:-
- Check the vital sign.
- Provide side line or lateral position.
- Clean the outer site of stoma with betadine gauze then use dry gauze.
- Advantage:-prevent the growth of bacteria and microorganism.
- prevent skin irritation due to stool and HCL produce irritation.
- maintain soft dry to the stoma.
- cover to the stoma with a water patch.
Advantage:-
- to prevent leakage of stool.
- water should be use/cut 1/8 inch more diameter than stoma.
- connect colostomy bag with ring of water.
- provide psychological support due to disturbed body image of client.
observe form stool:-
- Ascending colon:-Liquid
- Transverse:- Semi solid
- Sigmoid:-Normal
Observe the color of stoma:-
- Bright red or pink:-Normal finding.
- Pale Pink:-Normal in anemic patient.
- Black or dusky:-abnormal finding due to compromised of blood circulation.(inform to doctor)
- Malodorous/foul smell form stoma upto 72 hr. after colostomy is normal finding.
- foul smell form stoma after 72 hr. due to infection then nurse inform to doctor.
- colostomy bag empty when fill upto 1/3 lelvel.
- change the water and colostomy bag in 72 hrs in or 3 days.
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