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Friday, 26 November 2021

COLOSTOMY

 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:-

  1. Ascending colon:-Liquid
  2. Transverse:- Semi solid
  3. 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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