Ateneo de Zamboanga University College of Nursing NURSING SKILLS OUTPUT (NSO) Colostomy Irrigation

Description: A colostomy is an opening, called a stoma, which connects the colon to the surface of
the abdomen. This provides a new path for waste material and gas to leave the body after part of the colon or rectum is removed because of disease or injury. Colostomy irrigation is a way to regulate bowel movements by emptying the colon at a scheduled time. The process involves infusing water into the colon through the stoma. This stimulates the colon to empty. By repeating this process regularly -- once a day or once every second day -- the colon can be trained to empty with no spillage of waste in between irrigation. Colostomy irrigation
also can help you avoid constipation.

Material/equipment needed: For Colostomy irrigation: Disposable linen-saver pad Bath blanket Irrigation equipment y A bag to hold the solution y Tubing attached to the bag y Tubing clamp or flow regulator y #28 rubber colon catheter, calibrated in cm or inches with a stoma cone or seal y Disposable stoma irrigation drainage sleeve with belt to direct the fecal contents into the toilett IV pole Moisture-resistant bag Clean Gloves Lubricant Clean colostomy appliance or dressings Washcloth and towel Preparation: 1. Fill the solution bag with 500mL of warm(body temp) tap water or other solution as ordered. 2. Hang the solution bag on an IV pole so that the bottom of the container is at the level of the client s shoulder, or 30-45(12-18in) above the stoma. This height provides a pressure gravity that allows fluid to flow into the colon. 3. Attach the colon catheter securely to the tubing. 4. Open the regulator clamp and run fluid through the tubing to all air from it. Close the clamp until ready for the irrigation. Air should not be introduced into the bowel because it distends the bowel and can cause cramps.

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Before doing anything to the client, we must explain to him/her what is the procedure all about, why it is important and ways on how he/she can cooperate. This is done to gain the cooperation of the client. Wash hands, apply gloves and observe infection control procedures. This is done to avoid contamination and the cause of infection to the client. Provide for client privacy. Ensuring client s privacy will bring about the full cooperation of the client and promote the dignity of the client. Assist the client to turn on an appropriate side or assist in ambulatory client to sit on the toilet or on a commode. By doing this, the nurse can do the procedure without difficulty. Remove the colostomy bag and position the irrigation drainage sleeve. The soiled colostomy bag is placed inside a moisture-resistant bag to avoid transmission of microorganisms and reduces odor. Dilate the stoma, as ordered, by inserting the pinky finger. Before dilating the stoma, the finger is lubricated with water to prevent irritation to the stoma. Insert the stoma cone or colon catheter in a rotating motion after lubricating it with water. Lubrication of equipments is done for easy and smooth insertion and to prevent irritation. Irrigate the colon. This is done by opening the tubing clamp and letting the water from the bag flow into the bowel. This causes peristaltic movement inside the body and upon removal, it causes bowel to be excreted together with the water introduced to the body. Seal the drainage sleeve and allow complete emptying of the colon. Clean the drainage sleeve by letting water flow inside the sleeve and also clean the tip. Fold the tip and seal the bottom with a drainage clamp. Ask the client to move around for 30 minutes for complete emptying. Empty and remove the irrigation sleeve. This marks the end of the irrigation. Be sure to dispose all non-reusable items properly to avoid transmission of microorganisms. Clean all reusable items and return to its proper place. This is to prolong the life of the equipment. Clean the area surrounding the stoma and cover it with a new dressing. Cleanliness and dryness will make the client feel more comfortable. Provide comfort to the client. Comfort is important to help make the recovery faster. Document all findings. Any procedure done to the client must be written down in his/her chart. This is to protect the nurse from any untoward incidence.

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NURSING RESPONSIBILILTIES:

It is the nurse s responsibility to observe the rights of the client. On top of the responsibilities of a nurse is to ensure client s safety at all times. The nurse must check the client s condition before doing the procedure.

June 16, 2011 Date Jikko Verra M. Garcia BSN 3A

Clinical Instructor