OSTOMY CARE A Brief Overview Catherine Walsh RN,BSN,CWOCN
Types of Ostomies Colostomy= large intestine Ileostomy= small intestine Ileal Conduit/Urostomy=urine
Appliances Available One piece-Active Life=Cut-to-fit Two piece=Natura wafer and pouch, must match, cut-to-fit Pediatric Pouches=urostomy and drainable (colostomy), one piece Preemie=Newborn pouches-up to 10lbs
Additional Ostomy Supplies Stomahesive Paste Stomahesive barrier=4x4, 8x8 Colostomy clamps Colostomy deodorant Stoma dressing-Stomaseal-for non-producing stomas Skin prep (Coloplast),
Care Measure stoma with measuring guide. Cut wafer/base same size as stoma. If measuring guide not available, cut small then enlarge opening as needed. Never leave exposed skin to contact with effluent.
Care…continued Clean skin with water only Do not use perineal wipes or bath wipes around area for appliance when system is off pt
Care… Continued Paste is applied only to immediate area around stoma- like caulking a pipe Remove paper backing thick base first Apply to skin Skin prep only where tape goes Remove remaining paper.
Care…continued Fold pouch over clamp only once-more folds will break lock of clamp and leak Deodorant may be placed in pouch before clamping Urostomy pouches must be opened when attached to foley bag
Care…continued Empty ½ full Do not let fill to top-will leak Replace when leakage occurs Ileostomy and Urostomy not connected to foley bag will fill quickly-2 hours Empty/burp gas frequently-teach pt-can detach completely
Weartime: One piece pouch: 3-4 days or longer Two piece system: 5-7 days Contact WOCN nurse if changing more often