COLOSTOMY OR ILEOSTOMY CARE  Check the stoma regularly, the color should be

dark pink to red and moist.

Colostomy – is an opening, called a stoma in the
 Pale color indicates anemia
large intestine brought to the surface of the
 Dark or purple blue indicates compromised
abdomen for the purpose of evacuation of bowel.
circulation.
Indications:
Complications:
 Birth defects e.g. an imperforated anus
 Problems breathing
 Serious infection, such as diverticulitis
 Reactions to medications
 Inflammatory bowel disease
 Bleeding inside your belly
 Injury to the colon or rectum
 Damage to nearby organs
 Partial or complete intestinal or bowel
 Development of a hernia (occurs when an internal
blockage organ or other body part protrudes through the wall of muscle
 Rectal or colon cancer or tissue that normally contains it) at the site of the
 Wounds or fistulas  (an abnormal connection between surgical cut
an organ, vessel, or intestine and another organ, vessel or
 Falling in of the stoma (prolapse of the
intestine, or the skin) in the perineum
colostomy)
According to Stoma Site:  Infection, esp. in the lungs, urinary tract, or
 Ascending colostomy belly.
 Transverse colostomy  Narrowing or blockage of the colostomy
 Descending colostomy opening (stoma)
 Scar tissue forming in belly and causing
intestinal blockage
 Skin irritation
 Wound breaking open

Purposes of Colostomy Care:

1. Skin protection and care
2. Receptacle for drainage
3. Patient acceptance and self-care
4. To assess and care for the peristomal skin
5. To collect effluent for assessment of the
amount and type of output
6. To minimize odors for the client’s comfort
and self-esteem

Guidelines:
 Keep odor as free as of odor as possible
 Ostomy bag should be emptied frequently
 STEPS RATIONALE
1. Assess the used bag for leakage of effluent, and Because it can irritate the peristomal skin and a
any discomfort at or around the stoma. burning sensation may indicate breakdown beneath
the faceplate of pouch.

2. Assess the fullness of the pouch. It should be Because the weight may loosen the faceplate from
emptied when one-third to one-half full. skin, causing effluent to leak. If there’s any leakage
or discomfort, change appliance.

3. Select an appropriate time. Avoid time close to meal or visiting hours because
ostomy odor and effluent may reduce appetite or
embarrass the client. Avoid times immediately after
the administration of any medications that may
stimulate bowel evacuation.

4. Explain the procedure to the client and support Because supportive persons are often are supportive
person if properly informed.
5. Provide privacy, preferably in the bathroom where To avoid embarrassment on patient’s side.
client learn to deal with ostomy as they would at
home.
6. Assist pt. to a comfortable sitting or lying or To facilitate smother pouch application that is
standing position in the bathroom. avoiding wrinkles.
7. Wear gloves, and unfasten the belt if the client is To protect hand from contacting to the fecal matter.
wearing one.
8. Shave the peristomal skin of well-established Hair follicles can become irritated or infected by
ostomies as needed. Use an electric or safety razor repeated pulling out of the hairs during removal of
on a regular basis to remove excess heir. the appliance (bag) and skin barrier.
9. Empty the contents of the pouch through the To prevent spillage of effluent onto the client’s skin.
bottom opening into a bedpan and assess the
consistency and the amount of effluent.
10. Peel the bag off slowly while holding the client’s To minimize discomfort and prevent abrasion of the
skin taut (stretched or pulled tight; not slack). If the appliance skin.
is disposable, discard it in a moisture proof bag.
11. Inspect the stoma for color, size, shape and For early detection for presence of infection
bleeding and the peristomal skin any rednees,
ulceration, or irritation.
12. Clean and dry the peristomal skin and stoma. Soap is sometimes not advised because it can be
a. Use toilet Tissue to remove excess stool. Use irritating to the skin.
arm water, mild soap (optional), and cotton balls to
clean the skin and stoma.
b. Use a special skin cleaner to remove dried, To emulsify the stool, making removal less
hard stool. damaging to the skin.
c. Dry the area thoroughly by patting with a Because excess rubbing abrade the skin.
towel or cotton swabs.
d. Place a piece of tissue of gauze pad over the To absorb any see page from the stoma.
stoma, and change as needed
13. Apply paste – tape skin barrier if needed. Allow
the paste to dry for 1 to 2 minutes.
14. Prepare and apply the skin barrier (peristomal
seal)
15. Apply paste to any exposed skin around an
irregularly shaped stoma. Sprinkle peristomal
powder on the skin; wipe off the excess and dab
powder with slightly moist gauze or an applicator
moistened with a liquid skin barrier.
16. Remove the tissue over the stoma before
applying the pouch (either a disposable pouch with
adhesive square or reusable pouch with faceplate
attached)
17. Dispose equipment with cool water and mild To have it ready for the next use (if reusable).
soap, rinse and dry.
If feces are liquid, measure its volume before For future reference especially if the pt. is
emptying the feces into a toilet or hopper. experiencing diarrhea.
18. Remove and discard gloves.
19. Report any pertinent assessment such as any For future reference.
increase in stoma size, change color indicative of
circulatory impairment, and presence of skin
irritation or erosion.
Record on the client’s chart discoloration of the To prevent further damage.
stoma, the appearance of the peristomal skin; the
amount and type of drainage; the client’s fatigue,
discomfort, and significant behavior about ostomy.