SEMINAR ON MANAGEMENT OF

STOMAS, CATHETERS, TUBES,

WOUNDS AND DRAINAGES

BY
Sheela Rajakumari. J
MSc Nursing
MMM college of Nursing
 INTRODUCTION

In clinical setup there will be many patients with stomas,

catheters, tubes, wounds and drainages. The ultimate nursing care
should be based on the prevention of infection while giving care to
the patients. The proper management will reduce the incidence of
HAI’S and will help the patients to recover soon without
complications.
MANAGEMENTS OF STOMAS

A stoma is an opening on the abdomen that

can be connected to either the digestive or
urinary system to allow waste like urine or
faeces to be diverted out of the body.
INDICATIONS FOR OSTOMIES
UROSTOMY

A urostomy is a surgical
procedure that creates a stoma for
the urinary system. A urostomy is
made to avail for urinary diversion
in cases where drainage of urine
through the bladder and urethra is
not possible.
POSITIONS OF COLOSTOMIES
STOMA BAGS
STEPS OF STOMA CARE
MANAGEMENT
OF
CATHETERS
MEANING OF CATHETERS

Catheters are thin tubes made from medical

grade materials serving a broad range of
functions, they are inserted in the body to treat
disease or perform a surgical procedures.
 TYPES OF CATHETERS
ARTERIAL UMBILICA OTHER
L VENOUS
CATHETER CATHETER CATHETER CATHETER
S S S S
Umbilical artery
Intra arterial Intra venous
catheter Foleys catheter
catheter catheter
(UAC)

Pulmonary artery Umbilical venous Central line

catheter catheter (UVC)
catheter

Midline
catheter

PICC line
catheters

INTRAVENOUS CATHETER
Intravenous (IV) cannulation is a technique in
which a cannula is placed inside a vein to
provide venous access. Venous access allows
sampling of blood, as well as administration of
fluids, medications, parenteral nutrition,
chemotherapy, and blood products..
INTRA ARTERIAL
CATHETER
Intra-arterial catheters (also called arterial cannulas
or A-lines) are often inserted for invasive blood
pressure (BP) monitoring and intravascular access
for blood sampling in high-risk surgical and
critically ill patients.
 MIDLINE CATHETER
Midline catheters: A special type of catheter
used in a vascular access procedure that is
inserted inside a major vein for a period of
weeks so that blood can be repeatedly drawn or
medication and nutrients can be injected into
the patient's bloodstream on regular basis.
PICC LINE
A peripherally inserted central catheter, is a form
of intravenous access that can be used for a
prolonged period of time (e.g., for long
chemotherapy regimens, extended antibiotic
therapy, or total parenteral nutrition. It enters the
body through the skin at a peripheral site,
extends to the superior vena cava.
Pulmonary artery catheterization (PAC) is the insertion of a catheter into a pulmonary artery. Its
purpose is diagnostic; it is used to detect heart failure or sepsis, monitor therapy, and evaluate the 
effects of drugs. It is threaded through the right atrium of the heart, the right ventricle, and
subsequently into the pulmonary artery.
 Indications for IV cannulation include the following:
• Repeated blood sampling

• IV administration of fluid 

• IV administration of medications 

• IV administration of chemotherapeutic agents 

• IV nutritional support

• IV administration of blood or blood products 

• IV administration of radiologic contrast agents for computed tomography (CT),

magnetic resonance imaging (MRI), or nuclear imaging
 Indications for arterial cannulation include but are
not limited to:

• Continuous blood pressure monitoring

• Continuous mean arterial pressure monitoring

• Frequent arterial blood gas specimens

• Frequent blood sampling for diagnostic testing

Care of intravascular catheters
Conti..
Urinary catheter care
 Preparation
 Preparation of the child and family

• Gain patient/primary care givers consent for procedure

• Families/primary care givers should be given a thorough explanation of the procedure.

• Consider the need for a referral to play therapy to assist in explaining and preparing
the patient for the procedure.

• Nursing staff should discuss and plan procedural pain management with the child and
family prior to the procedure. This may include non pharmalogical (including
distraction techniques) and pharmalogical considerations.
Prepare the following equipment:
Dressing trolley
Catheterization pack and drapes
Sterile gloves
Appropriate size catheter (see 
catheter size guideline below)
Sterile Lubricant and/or Xylocaine jelly syringe
(plain sterile lubricant for infants)
Sterile water to inflate balloon (normal saline
can crystallise and render the balloon porous,
causing its deflation and the risk of catheter
loss)
5ml/10ml Syringe – as stated on catheter
packaging
Specimen jar
Sterile normal saline
Straps/tape to secure catheter to leg
Drainage bag
Waterproof sheet
 CATHETER SIZE
Age  Weight  Foley 
 Neonate   <1200g  3.5 Fr umbilical catheter

 Neonate  1200-1500g  5 Fr umbilical catheter

 Neonate  1500-2500g  5 Fr umbilical catheter or size 6

Nelaton

 0-6 months  3.5-7kg  6

 1 year  10kg  6 – 8, preferably 8

 2 years  12kg  8
 3 years  14kg  8-10
 5 years  18kg  10
 6 years  21kg  10
 8 years  27kg  10-12
 12 years  varies  12-14
 UMBILICAL CATHETER

UMBILICAL ARTERY CATHETER (UAC)

UAC is used to provide direct access in the
neonates for sampling and monitoring

UMBILICAL VEIN CATHETER (UVC)

UAV access in infants <800 gms as a route
for resuscitation drugs and fluids, with the
catheter placements at the inferior vena cava
NURSING MANAGEMENT
 MANAGEMENT OF TUBES AND DRAINS
DEFINITION OF DRAINS:
A drain is a thin tube inserted at
the surgery site to remove extra
fluids and tissue after surgery. The
drain is attached to a collection bag.
 NURSING CARE OF DRAIN
 After the insertion, the drains are fixed with non absorbable suture and

dressing must be done with petroleum gauze or plain sterile gauze.

 Continuous monitoring

 Dressing and drain tubes should be checked for any soakage

 The measurement of drain should be noted

 Color of drain

 The site should be assessed in every shift for infection

NASOGASTRIC TUBE
MANAGEMENT OF WOUND
THEORY APPLICATION
JOURNAL ABSTRACT
THANK YOU