1. Understanding Ostomies Get Out Your Unit 20.9 Worksheet out !!

2. Ostomies 450,000 people in the US have an ostomy 120,000 Surgical Procedures a year There are psychological, social, financial, and physical implications

3. Stoma A stoma is a permanent or temporary opening made in the abdominal wall through a surgical procedure Any portion of the bowel or urinary tract can be exteriorized to create a stoma.

4. Types of Ostomies Permanent Ostomies: Are constructed when the rectum, the colon, or the bladder have been removed Temporary Ostomies: May be placed in the small or large intestine or the urinary tract. They are generally reversed in 3 to 6 months.

5. Types of Stomas End Stoma: The end of the bowel is inverted at the skin surface Loop Stoma: The entire bowel is brought to the skin surface and opened to create a distal, or nonfunctioning end, and a proximal-functioning end Double-Barrel Stoma: Similar to a loop except it is divided into two separate stomas; one a mucous fistula and the other a functioning stoma.

6. Complications of Stomas Necrotic and non- functioning

7. Prolapsed Resembles a Hernia

8. Retracted

9. Indications for an Ileostomy ( Small Bowel Resection) Cancer Crohn’s Disease Ulcerative Colitis Any Disease that requires the removal of the entire Large Intestine

10. Colostomies Ascending Colon Formed?

11. Colostomies Transverse Colon Formed?

12. Colostomy Descending

13. Indications for Colostomies Cancer of the Colon or Rectum Acute Diverticulitis, Gunshot/Stab Wounds, and any other acute and destructive event Radiation Therapy

14. Patient Assessment Vision Problems Hand Tremors, Paralysis, CVA, or Arthritis Live Alone Current Medication Employment Recreational Hobbies Sexual Activity

15. Stool Consistency Colostomy: Formed Ileostomy: Liquid Consistency Transverse Colostomy: Liquid and Pasty

16. Post-Op Assessment Stoma: Rich Blood Supply, Edema Round vs Oval Look for a Decrease after 8 weeks Redness Stitches Mucus

17. Stoma Complications Candidiasis= Yeast Related Infection Folliculitis= hair trauma Irritant Dermatitis= Inflammation of the skin around the stoma

18. Dietary Concerns Few Restrictions Well Balanced with adequate fluid intake Small frequent meals Low fiber Diet in the first 6 weeks Drink 8 glasses of water a day

19. Dietary Considerations Foods that Cause Blockage: Corn, Dried Fruit, Bean Sprouts, Celery, Raw Vegetables in Excess, Bamboo, Mushrooms, and Foods with seeds Foods that cause Loose Stools: Fruit juices, Baked Beans, Highly Spiced Foods, Cabbage, and Broccoli Foods that Thicken Stool:Cheese, Rice, and Pastas Foods that Cause Odor: Asparagus, Cabbage, Eggs, Fish, Onions, Dried Beans, and Beer

20. Ostomy Care 1. Wash your Hands Assemble your Equipment Wear Gloves Clean around the stoma Observe the Stoma Measure the stoma

21. Measure the Stoma Transfer the Measurement to the Wafer Cut the Wafer to Fit Remember to keep the area dry and be ready for drainage

22. Peal the Adhesive Backing off and Gently adhere the Wafer to the Patient You may use Soma Paste to further seal and protect the skin

23. Gently attach the Bag to the Ring around the Wafer Make sure the seal is tight and secure Make sure the bag is clipped at the bottom

24. Prepare for Drainage and Always Document the Procedure