Nursing management of pt requiring an ostomy Questions with 100% Correct Answers.

Colostomy: Correct Answer Surgical opening into the colon by means of stoma to allow drainage of contents of the colon Disturbed body image: Correct Answer - Encourage pt to verbalize feelings about the stoma. Offer to be present when the stoma is first viewed and touched - Suggest that the spouse or significant other view the stoma to reduce fears of their response - Off counseling if desired - Arrange for a visit, phone call, or online chat with another pt with a stoma Anxiety related to loss of bowel control: Correct Answer 1. Explain how to prepare the appliance for an adequate fit - Choose drainage applicant that will provide a secure fit around the stoma size with a measuring guide provided by ostomy equipment - barrier opening should be sized to "hug" the stoma and cover the peristomal skin - Wafer barriers can be pulled or molded to the size of stoma - Remove any plastic covering that protects the appliance adhesive - Ouch is applied by pressing the adhesive for 30sec to the skin barrier 2. Demonstrate how to change the appliance or empty the pouch before leakage occurs 3. Demonstrate how to irrigate the colostomy (usually on 4-5th day) Risk for impaired skin integrity: Correct Answer 1. Provide info about S/S of irritated or inflamed skin. Use pictures if possible 2. Instruct patient how to cleanse the peristomal skin gently - Mild friction and warm water and a gentle soap cleanses the skin and minimizes irritation and possible abrasions - After rinsing the soap, patting the skin dry prevents tissue trauma 3. Demonstrate how to apply a skin barrier which protect skin from enzymes and bacteria 4. Demonstrate how to remove the pouch - Gently separate the skin from the adhesive to avoid irritation - Start at the top keeping the surrounding skin taunt, if feel resistance use warm water or adhesive pad to remove