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10 Ileostomy and Colostomy Nursing Care Plans

An ileostomy is an commencement fabricated in the farthest ileum to discourse regional and ulcerative colitis and to entertain intestinal interruption in colon cancer, polyps, and trauma. It is usually effected when the perfect colon, rectum, and anus must be removed, in which contingency the ileostomy is beaming. A partial ileostomy is effected to stipulate perfect bowel intermission in stipulations such as constant colitis and in some trauma contingencys.Ileostomy and Colostomy A colostomy is a pastime of the abundant of the colon and may be partial or beaming. Ascending, across, and sigmoid colostomies can be performed. Across colostomy is usually partial. A sigmoid colostomy is the most spiritless beaming stoma ,used in performing cancer discoursement.Ileostomy and Colostomy

Nursing Prudence Plans

Nursing prudence skillful-composition and planning for resigneds delay ileostomy or colostomy includes: abetting the resigned and/or SO during the structure, checkmateing complications, stay anarchy in self-care, stipulate advice encircling procedure/prognosis, discoursement scarcitys, and virtual complications. Here are 10 nursing prudence plans (NCP) and nursing singularity for resigneds delay fecal pastimes: colostomy and ileostomy:
  1. Risk for Impaired Bark Integrity
  2. Disturbed Body Image
  3. Acute Pain
  4. Impaired Bark Integrity
  5. Deficient Fluid Volume
  6. Risk for Imbalanced Nutrition: Less Than Body Requirements
  7. Risk for Sexual Dysfunction
  8. Disturbed Sleep Pattern
  9. Risk for Constipation or Diarrhea
  10. Deficient Knowledge
  11. Other Nursing Prudence Plans

Risk for Impaired Bark Integrity

Nursing Diagnosis Risk factors may include
  • Absence of sphincter at the stoma
  • Character/flow of abundant and flatus from the stoma
  • Reaction to result/chemicals; unbecoming fitting/prudence of agency/skin
Possibly evidenced by
  • Not conducive. A facilitate singularity is not evidenced by signs and symptoms, as the gist has not occurred and nursing interferences are directed at interruption.
Desired Outcomes
  • Client allure practise bark parity about the stoma.
  • Client allure fulfill identical facilitate factors.
  • Client allure manifest behaviors/techniques to aid salutiferous/checkmate bark breakdown.
Nursing Interventions Rationale
Inspect stoma and peristomal bark area delay each pouch veer. Note effeminacy, bruises (dark, blue-colored distortion), rashes Monitors the salutiferous way and usefulness of agencys and identifies areas of solicitude, scarcity for exalt evaluation and interference. Early identification of stomal necrosis or ischemia or fungal infection (from veers in recognized bowel flora) stipulates for opportune interferences to checkmate earnest complications. Stoma should be red and juicy. Ulcerated areas on stoma may be from a pouch commencement that is too trivial or a faceplate that cuts into stoma. In resigneds delay an ileostomy, the abundant is abundant in enzymes, increasing the relishness of bark effeminacy. In resigned delay a colostomy, bark prudence is not as vast a solicitude accordingly the enzymes are no longer offer in the abundant.
Clean delay irascible water and pat dry. Use soap solely if area is habituated delay glutinous stool. If paste has calm on the bark, let it dry, then bark it off. Maintaining a clear and dry area helps checkmate bark breakdown.
Measure stoma periodically: at meanest weekly for original 6 wk, then uninterruptedly a month for 6 mo. Measure twain width and prolixity of stoma. As postoperative edema resolves (during original 6 wk), the stoma shrinks and greatness of agency must be altered to secure becoming fit so that abundant is calm as it flows from the ostomy and apposition delay the bark is checkmateed.
Verify that commencement on jealous support of the pouch is at meanest 1⁄16 to 1⁄8 in (2–3 mm) larger than the cheap of the stoma, delay large jealousness left to apportion pouch. Prevents trauma to the stoma construction and protects the peristomal bark. Large jealous area checkmates the bark separation wafer from substance too tidy. Note: Too tidy a fit may producer stomal edema or stenosis.
Use a pellucid, odor-proof drainable pouch. A pellucid agency during original 4–6 wk allows indulgent notice of stoma delayout want of removing pouch/blistering bark.
Apply misspend bark separation: hydrocolloid wafer, karaya gun, extended-wear bark separation, or common results. Protects bark from pouch jealous, enhances jealousness of pouch, and facilitates non-location of pouch when expedient. Note: Sigmoid colostomy may not demand use of a bark separation uninterruptedly stool becomes formed and elimination is regulated through irrigation.
Empty, wet, and clearse ostomy pouch on a order plea, using misspend equipment. Frequent pouch veers are blistering to the bark and should be avoided. Emptying and rinsing the pouch delay the becoming key not solely removes bacteria and odor-causing stool and flatus but besides deodorizes the pouch.
Support excluded bark when gently removing agency. Apportion jealous removers as implied, then bathe entirely. Prevents construction effeminacy or damnation associated delay “pulling” pouch off.
Investigate reports of burning, hankering, or blistering about stoma. Indicative of abundant leakage delay peristomal effeminacy, or possibly Candida contagion, requiring interference.
Evaluate jealous result and agency fit on ongoing plea. Provides occasion for gist solving. Determines scarcity for exalt interference.
Consult delay conscious damage, ostomy, chastity nurse. Helpful in choosing results misspend for resigned’s detail rehabilitation scarcitys, including mold of ostomy, physical/mental foundation, abilities to touch self-care, and financial resources.
Apply corticosteroid aerosol limb and prescribed antifungal scatter as implied. Assists in salutiferous if peristomal effeminacy persists and/or fungal contagion develops. Note: These results can bear energetic cause property and should be used reservedly.
You may besides relish the aftercited posts and prudence plans: Gastrointestinal Prudence Plans Care plans envelope the disorders of the gastrointestinal and digestive system:


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