reviewer

• Types of ostomy


  • Urostomy (Urinary Diversion)
  • Colostomy
  • Ileostomy
• Ostomy


  Causes a change in the way urine or stool exits the body as a result of a surgical procedure. Bodily waste is rerouted from its usual path because of malfunctioning parts of the urinary or digestive system. An ostomy can be temporary or permanent
• Ostomy surgery


  Life-saving procedure that allows bodily waste to pass through a surgically created stoma on the abdomen into a prosthetic known as a ‘pouch’ or ‘ostomy bag’ on the outside of the body or an internal surgically created pouch for continent diversion surgeries
• Reasons for ostomy surgery

  • Birth defects, cancer, inflammatory bowel disease, diverticulitis, incontinence, severe abdominal or pelvic trauma, injuries sustained during military service
• Ostomy or continent diversion surgery can occur at any age and does not lower life expectancy but is the start of a “new normal” life
• Stoma


  The opening created by ostomy surgery. It is located on the abdomen and is dark pink in color. For most ostomies, a pouch is worn over the stoma to collect stool or urine. For some people, it is possible to have a continent diversion, an alternative to a conventional ostomy that eliminates the necessity for a pouch
• Urostomy (Urinary Diversion)


  A surgically created opening in the abdominal wall through which urine passes. Common types are ileal conduit and colonic conduit. Reasons for surgery include bladder cancer, spinal cord injuries, chronic infection of the bladder, and birth defects such as spina bifida
• Care of Urostomy


  A pouching system is worn. Pouches are odor-free and come in many different types to fit body contours, personal preferences, and lifestyle. Ostomy supplies are available at medical supply stores and through the mail and are covered by most health insurance plans
• Colostomy


  A surgically created opening in the abdomen where a piece of the colon is brought outside the abdominal wall to create a stoma through which digested food passes into an external pouching system. Temporary colostomy may be required to give a portion of the bowel a chance to rest and heal, while permanent colostomy may be required when a disease affects the end part of the colon or rectum. Reasons for surgery include cancer, diverticulitis, imperforate anus, Hirschsprung’s disease, trauma, among others
• Ileostomy


  A surgically created opening in the abdomen where a piece of the ileum is brought outside the abdominal wall to create a stoma through which digested food passes into an external pouching system
• Reasons for surgery involving the end part of the colon or rectum include Cancer, diverticulitis, imperforate anus, Hirschsprung’s disease, trauma, other
• Temporary ileostomy


  May be required when a surgical site lower in the digestive tract needs time to heal. Examples include colorectal cancer surgeries, diverticulitis surgery, j-pouch surgery for ulcerative colitis or familial polyposis. Usually constructed with a “loop” stoma
• Permanent ileostomy


  May be required when the large intestine is removed and reconnection to the anus isn’t feasible. Possible causes include Crohn’s disease, some cancers, colonic dysmotility, some cases of ulcerative colitis or familial polyposis. Usually constructed with an “end” stoma
• Ostomy


  A surgically created opening from the urinary tract or intestines, where effluent (fecal matter, urine, or mucous) is rerouted to the outside of the body using a stoma
• Stoma


  An artificially created opening through which effluent is rerouted to the outside of the body
• Types of ostomies


  • Colostomy
  • Ileostomy
  • Urostomy or ileal conduit
• An ostomy is named according to the part of intestine used to construct it
• Pouching system should be changed every 4 to 7 days, depending on the patient and type of pouch
• Consult a wound care specialist if there is skin breakdown, pouch leaks, or other concerns related to the pouching system
• Patients should participate in the care of their ostomy, and health care providers should promote patient involvement
• Wound care specialist consultation

  1. Skin breakdown

  2. Pouch leakage

  3. Concerns related to the pouching system
• Patient care of ostomy


  • Patients should participate in the care of their ostomy
  • Health care providers should promote patient and family involvement
• Pouch emptying recommendation


  • Encourage the patient to empty the pouch when it is one-quarter to one-half full of urine, gas, or feces
• Ostomy product choices


  • Based on the patient’s needs and preference
• Ostomy procedure


  1. Perform hand hygiene

  2. Gather supplies

  3. Identify the patient and review the procedure

  4. Create privacy

  5. Remove ostomy bag and measure and empty contents

  6. Remove flange

  7. Clean stoma gently

  8. Assess stoma and peristomal skin

  9. Measure the stoma diameter and cut out stoma hole

  10. Apply flange over stoma

  11. Apply the ostomy bag

  12. Hold palm of hand over ostomy pouch for 2 minutes to assist with appliance adhering to skin

  13. Clean up supplies and place patient in a comfortable position

  14. Remove garbage from patient’s room

  15. Perform hand hygiene

  16. Document procedure
• Stoma characteristics
• Speaker: 'Evolve. Adapt. Overcome.'
• CEFI is now ready
• WINSTON POLECINA, RN, College of Nursing