Stoma Care Resume

Bianti Ayu Dwiputri, 1706038840, Medical-Surgical II Practice – A

Ostomy is a surgical condition where the inside of an organ is formed

outside (Lynn, 2011). The part that is attached to the skin by suturing the mucosa
of the organ to the skin is called stoma. There are two kinds of ostomy based on
the video: (1) Ileostomy; it is located in the ileum, and (2) Colostomy; it is
located in the colon. This stoma is used to help the patient to empty the colon or
ileum by exiting the feces though the stoma (Lynn, 2011). The indication that a
patient needs ostomy because they experienced (Maria, 2020): (1) Cancer, (2)
Congenital defect, (3) inflammation in the intestine, (4) polyposis familial
syndrome, and (5) trauma in the intestine.

As we can see from the video, the principal of changing ostomy appliance
is the clean principal. We need to make sure that the surrounding and our hands
are clean and we need to keep the stoma clean (Memorial Sloan Kettering, 2016).

Procedures:

1. From the video (Memorial Sloan Kettering, 2016)

trace the size in

place the wafer
Empty the the wafer and cut
with the
colostomy it according to the
colostomy bag
size

measure the
stoma using the place carefully in
wash hands
measurement the stoma part
device

Carefully remove clean around the

the addhesive part stoma using
wash hands
and remove the washclothes with
bag warm water

change the
put the used
colostomy within
appliance in the wash hands
4-5 days or when
trash bag
leakage is appears
 2. From (Novieastari & Supartini, 2015)

clean the are

around the measure the
stoma using stoma using
washclothes measurement
with warm device
therapeutic water
communicati
on with the assess the Choose the
client client's self- right bag and
care ability wafer based
on the
keep the measurement
client's Assess the
privacy abdomen
place
carefully on Change the
the stoma part colostomy
Wash hands Measure the within 3-7
stoma days or when
put away the leakage is
handgloves appears
Use the observe the
handgloves wafer,
stoma's assess the
condition, the wash hands client's
auscultate the patient's feeling
bowel sounds feces and
fluid

The video shows us the colostomy care for the patient self-care. The
difference from what I read in (Novieastari & Supartini, 2015) and from the video
is that the patient didn’t examine nor assess the stoma’s condition. Based on
(Novieastari & Supartini, 2015), it is needed to examine or assess the stoma
condition to determine whether the patient experience stoma infection or not. The
examination is also needed to identify the types of stoma bag to be used by the
patient. It is also important to assess the result of the feces to determine any
problems in the gastrointestinal system. The video shows that the patient only
assesses or measures the stoma only to determine the proper size of the wafer to
be use.

Because the video only shows us how to do self-care for changing ostomy
appliances, we as nurses should also know that it is important to assess the bowel
sound of the patient before changing the ostomy appliances. This procedure is
needed to check the patient’s peristaltic movement in the intestine (Novieastari &
Supartini, 2015).

From what we can highlight in the video and also in the guidance book, it is
very important to keep our hands clean by washing it effectively. It is needed to
keep our hands clean to prevent any infection risk with the stoma or to just
minimize the risk of infection for ourselves. This is why the usage of hand gloves
for nurse who’s taking care for the stoma is important. This action is to prevent us
from direct contact with the patient’s body fluid or body waste (Lynn, 2011). To
also prevent infection in patient with stoma, it is important to change the
colostomy appliance within 4 to 5 days (Memorial Sloan Kettering, 2016) or 3 to
7 days (Novieastari & Supartini, 2015) or when there is leakage appearance in the
appliance.

Bibliography
Lynn, P. (2011). Taylor's clinical nursing skills: A nursing process approach (3rd ed.).
Philadelphia: Wolters Kluwer Health | Lippincott Williams & Wilkins.

Maria, R. (2020, March 17). Penggantian Kantong Kolostomi. Depok, West Java,
Indonesia.

Memorial Sloan Kettering. (2016, January 5). How to Change Your Ostomy Appliance.
Manhattan, New York City, United States.

Novieastari, E., & Supartini, Y. (2015). Keperawatan dasar: Manual keterampilan klini
(Edisi Indonesia). Jakarta: Elsevier.