Changing And Emptying Ostomy Appliance

Preparatory Step (1.1) Critical Action

Purpose:

a. To allow fecal material to drain freely from the ostomy appliance.

b. To prevent leaking and skin breakdown around the stoma.

.‫ ﻟﻠﺴﻤﺎح ﻟﻠﻤﻮاد اﻟﺒﺮازﯾﺔ ﺑﺎﻟﺘﺼﺮﯾﻒ ﺑﺤﺮﯾﺔ ﻣﻦ ﺟﮭﺎز اﻟﻔﻐﺮة‬.‫أ‬

‫ ﻟﻤﻨﻊ اﻟﺘﺴﺮب وﺗﻜﺴﺮ اﻟﺠﻠﺪ ﺣﻮل اﻟﺜﻐﺮة‬.‫ب‬

Preparatory Step (1.2) Critical Action

Equipment:

• A new pouch (a 1-piece system, or 2-piece system that has a wafer)

• Basin with warm water
• Skin cleanser/soap, towel, washcloth
• Silicone-based adhesive remover •
• Gauze squares
• Washcloth or cotton balls
• Skin protectant such as Skin Prep
• One-piece/ Two-piece ostomy appliance
• Closure/ Pouch clip
• Stoma measuring guide
• Graduated container
• bedpan
• Ostomy belt (optional)
• Disposable gloves
• Pen or pencil
• Small plastic trash bag
• Waterproof disposable pad
• Additional PPE, as indicated
 ‫اﻷدوات ‪:‬‬
‫• ﻛﯿﺲ ﺟﺪﯾﺪ )ﻧﻈﺎم ﻣﻦ ﻗﻄﻌﺔ واﺣﺪة أو ﻧﻈﺎم ﻣﻦ ﻗﻄﻌﺘﯿﻦ ﺑﮫ رﻗﺎﻗﺔ(‬
‫• ﺣﻮض ﺑﻤﺎء داﻓﺊ‬
‫• ﻣﻨﻈﻒ ﻟﻠﺠﻠﺪ ‪ /‬ﺻﺎﺑﻮن ‪ ،‬ﻣﻨﺸﻔﺔ ‪ ،‬ﻗﻤﺎﺷﺔ‬
‫• ﻣﺰﯾﻞ ﻻﺻﻖ ﻗﺎﺋﻢ ﻋﻠﻰ اﻟﺴﯿﻠﯿﻜﻮن •‬
‫• ﻣﺮﺑﻌﺎت اﻟﺸﺎش‬
‫• ﻣﻨﺸﻔﺔ أو ﻛﺮات ﻗﻄﻨﯿﺔ‬
‫• واﻗﻲ ﻟﻠﺒﺸﺮة‬
‫• ﺟﮭﺎز ﻓﻐﺮ ﻣﻦ ﻗﻄﻌﺔ واﺣﺪة ‪ /‬ﻗﻄﻌﺘﯿﻦ‬
‫• اﻹﻏﻼق ‪ /‬اﻟﺤﻘﯿﺒﺔ ﻛﻠﯿﺐ‬
‫• دﻟﯿﻞ ﻗﯿﺎس اﻟﻔﻐﺮة‬
‫• ﺣﺎوﯾﺔ ﻣﺘﺪرﺟﺔ‬
‫• اﻟﺴﺮﯾﺮ‬
‫• ﺣﺰام )اﺧﺘﯿﺎري(‬
‫• ﻗﻔﺎزات ﯾﻤﻜﻦ اﻟﺘﺨﻠﺺ ﻣﻨﮭﺎ‬
‫• ﻗﻠﻢ أو ﻗﻠﻢ رﺻﺎص‬
‫• ﻛﯿﺲ ﻗﻤﺎﻣﺔ ﺑﻼﺳﺘﯿﻚ ﺻﻐﯿﺮ‬
‫• وﺳﺎدة ﻣﻀﺎدة ﻟﻠﻤﺎء ﯾﻤﻜﻦ اﻟﺘﺨﻠﺺ ﻣﻨﮭﺎ‬
‫• ﻣﻌﺪات اﻟﺤﻤﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ اﻹﺿﺎﻓﯿﺔ ‪ ،‬ﻛﻤﺎ ھﻮ ﻣﺤﺪد‬

‫‪Page 82‬‬
 Preparatory Step (2.1) Critical Action
Assessment:
1. Assess current condition of ostomy appliance and stoma (color, size and shape, if bag is clear).
2. Determine the patient’s knowledge and complaints about ostomy care.
3. Assess the skin surrounding the stoma (bleeding, swelling, irritation).
4. Assess the amount, type, color, consistency, and odor of stool from ostomy.
5. The client’s and family members’ learning needs regarding the ostomy and self-care.
6. The client’s emotional status, especially strategies used to cope with the ostomy.
7. Assess the fullness of the pouch.
: ‫( ﺗﻘﯿﯿﻢ اﻟﻌﻤﻞ‬2.1) ‫اﻟﺨﻄﻮة اﻟﺘﺤﻀﯿﺮﯾﺔ‬
.(‫ إذا ﻛﺎن اﻟﻜﯿﺲ ﻧﻈﯿﻔًﺎ‬، ‫ ﺗﻘﯿﯿﻢ اﻟﺤﺎﻟﺔ اﻟﺤﺎﻟﯿﺔ ﻟﺠﮭﺎز اﻟﻔﻐﺮة واﻟﻔُْﻐﺮة )اﻟﻠﻮن واﻟﺤﺠﻢ واﻟﺸﻜﻞ‬.1
.‫ ﺗﺤﺪﯾﺪ ﻣﻌﺮﻓﺔ اﻟﻤﺮﯾﺾ وﺷﻜﺎوي ﺣﻮل رﻋﺎﯾﺔ اﻟﻔﻐﺮ‬.2
.(‫ ﺗﮭﯿﺞ‬، ‫ ﺗﻮرم‬، ‫ ﻗﻢ ﺑﺘﻘﯿﯿﻢ اﻟﺠﻠﺪ اﻟﻤﺤﯿﻂ ﺑﺎﻟﻔﺘﺤﺔ )ﻧﺰﯾﻒ‬.3
.‫ ﻗﻢ ﺑﺘﻘﯿﯿﻢ ﻛﻤﯿﺔ وﻧﻮع وﻟﻮن واﺗﺴﺎق وراﺋﺤﺔ اﻟﺒﺮاز ﻣﻦ اﻟﻔﻐﺮة‬.4
.‫ اﺣﺘﯿﺎﺟﺎت اﻟﺘﻌﻠﻢ ﻟﻠﻌﻤﯿﻞ وأﻓﺮاد اﻷﺳﺮة ﻓﯿﻤﺎ ﯾﺘﻌﻠﻖ ﺑﺎﻟﻔﻐﺮ واﻟﺮﻋﺎﯾﺔ اﻟﺬاﺗﯿﺔ‬.5
.‫ وﺧﺎﺻﺔ اﻻﺳﺘﺮاﺗﯿﺠﯿﺎت اﻟﻤﺴﺘﺨﺪﻣﺔ ﻟﻠﺘﻌﺎﻣﻞ ﻣﻊ اﻟﻔﻐﺮ‬، ‫ اﻟﺤﺎﻟﺔ اﻟﻌﺎطﻔﯿﺔ ﻟﻠﻌﻤﯿﻞ‬.6
.‫ ﺗﻘﯿﯿﻢ اﻣﺘﻼء اﻟﺤﻘﯿﺒﺔ‬.7

Preparatory Step (2.2)

Nursing Diagnosis:
• Risk for Impaired Skin Integrity ‫ • ﺧﻄﺮ ﺣﺪوث ﺧﻠﻞ ﻓﻲ ﺳﻼﻣﺔ اﻟﺠﻠﺪ‬Constipation ‫إﻣﺴﺎك‬
• Ineffective Coping ‫• اﻟﺘﺄﻗﻠﻢ ﻏﯿﺮ اﻟﻔﻌﺎل‬ Disturbed Body Image ‫ﺻﻮرة اﻟﺠﺴﻢ اﻟﻤﻨﺰﻋﺠﺔ‬
• Deficient Knowledge ‫ﻧﻘﺺ اﻟﻤﻌﺮﻓﮫ‬ Diarrhea ‫اﻻﺳﮭﺎل‬

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 IMPLEMENTATION

Critical Action

Step Action Rationale

Yes No

1. Follow Standard Protocol: This ensures that the correct intervention is

performed on the correct patient.
Verify or Check Doctor’s Order. ‫ھﺬا ﯾﻀﻤﻦ إﺟﺮاء اﻟﺘﺪﺧﻞ اﻟﺼﺤﯿﺢ ﻋﻠﻰ اﻟﻤﺮﯾﺾ اﻟﺼﺤﯿﺢ‬
Identifying the patient ensures the right patient
Identify the patient.
receives the intervention and helpsrelive
Introduce yourself and explain the anxiety.
procedure. ‫ﯾﻀﻤﻦ اﻟﺘﻌﺮف ﻋﻠﻰ اﻟﻤﺮﯾﺾ أن ﯾﺘﻠﻘﻰ اﻟﻤﺮﯾﺾ اﻟﻤﻨﺎﺳﺐ‬
‫اﻟﺘﺪﺧﻞ وﯾﺴﺎﻋﺪ ﻓﻲ ﺗﺨﻔﯿﻒ اﻟﻘﻠﻖ‬
Provide privacy and position comfortably. This ensures the patient’s privacy.
‫ھﺬا ﯾﻀﻤﻦ ﺧﺼﻮﺻﯿﺔ اﻟﻤﺮﯾﺾ‬
Perform hand hygiene and put on PPE if
indicated. Hand hygiene and PPE prevent the spread of
.‫ اﻟﺘﻌﺮف ﻋﻠﻰ اﻟﻤﺮﯾﺾ‬.‫ﺗﺤﻘﻖ أو ﺗﺤﻘﻖ ﻣﻦ طﻠﺐ اﻟﻄﺒﯿﺐ‬ microorganisms. PPE is required based on
.‫ﻗﺪم ﻧﻔﺴﻚ واﺷﺮح اﻹﺟﺮاء‬ Transmission Precautions.
.‫ﺗﻮﻓﯿﺮ اﻟﺨﺼﻮﺻﯿﺔ واﻟﻤﻮﻗﻒ ﺑﺸﻜﻞ ﻣﺮﯾﺢ‬
‫ﺗﻤﻨﻊ ﻧﻈﺎﻓﺔ اﻟﯿﺪﯾﻦ وﻣﻌﺪات اﻟﺤﻤﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ اﻧﺘﺸﺎر‬
‫ﻗﻢ ﺑﺘﻨﻈﯿﻒ اﻟﯿﺪﯾﻦ وارﺗﺪ ﻣﻌﺪات اﻟﻮﻗﺎﯾﺔ‬ ‫ ﻣﻄﻠﻮب ﻣﻌﺪات اﻟﺤﻤﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ‬.‫اﻟﻜﺎﺋﻨﺎت اﻟﺪﻗﯿﻘﺔ‬
‫اﻟﺸﺨﺼﯿﺔ إذا ﻟﺰم اﻷﻣﺮ‬ ‫ﺑﻨﺎًء ﻋﻠﻰ اﺣﺘﯿﺎطﺎت اﻟﻨﻘﻞ‬

Page 84
2. Bring necessary equipment to the
bedside stand or overbed table.
‫أﺣﻀﺮ اﻟﻤﻌﺪات اﻟﻼزﻣﺔ إﻟﻰ ﺣﺎﻣﻞ اﻟﺴﺮﯾﺮ أو طﺎوﻟﺔ‬
.‫اﻟﺴﺮﯾﺮ‬
Arranging items nearby is convenient, saves time,
and avoids unnecessary stretching andtwisting of
muscles on the part of the nurse.
‫ﯾﻌﺪ ﺗﺮﺗﯿﺐ اﻟﻌﻨﺎﺻﺮ اﻟﻘﺮﯾﺒﺔ أﻣًﺮا ﻣﺮﯾًﺤﺎ وﯾﻮﻓﺮ اﻟﻮﻗﺖ‬
‫وﯾﺘﺠﻨﺐ اﻟﺸﺪ واﻟﺘﻮاء ﻏﯿﺮ اﻟﻀﺮوري ﻟﻠﻌﻀﻼت ﻣﻦ ﺟﺎﻧﺐ‬
.‫اﻟﻤﻤﺮﺿﺔ‬

3. Assist patient to a comfortable sitting orlying Proper positioning will allow the patient to view
position in bed or a standing or sitting the procedure in preparation to learn to perform
position in the bathroom. it independently. Lying flat or sitting upright
facilitates smooth applicationof the appliance.
‫ﺳﯿﺴﻤﺢ اﻟﻮﺿﻊ اﻟﻤﻨﺎﺳﺐ ﻟﻠﻤﺮﯾﺾ ﺑﻤﺸﺎھﺪة اﻹﺟﺮاء اﺳﺘﻌﺪادًا‬
‫ اﻻﺳﺘﻠﻘﺎء أو اﻟﺠﻠﻮس ﻓﻲ وﺿﻊ‬.‫ﻟﺘﻌﻠﻢ ﻛﯿﻔﯿﺔ ﺗﻨﻔﯿﺬه ﺑﺸﻜﻞ ﻣﺴﺘﻘﻞ‬
.‫ﻣﺴﺘﻘﯿﻢ ﯾﺴﮭﻞ اﻟﺘﻄﺒﯿﻖ اﻟﺴﻠﺲ ﻟﻠﺠﮭﺎز‬

‫ﺳﺎﻋﺪ اﻟﻤﺮﯾﺾ ﻋﻠﻰ اﻟﺠﻠﻮس أو اﻟﺠﻠﻮس اﻟﻤﺮﯾﺢ ﻓﻲ‬

.‫اﻟﺴﺮﯾﺮ أو اﻟﻮﻗﻮف أو اﻟﺠﻠﻮس ﻓﻲ اﻟﺤﻤﺎم‬
4. EMPTYING AN APPLIANCE:
:‫إﻓﺮاغ اﻟﺠﮭﺎز‬
Put on disposable gloves. Remove clampandfold Gloves prevent contact with blood, body fluids,
end of pouch upward like a cuff. and microorganisms. Creating a cuff before
emptying prevents additional soilingand odor.
‫ ﻗﻢ ﺑﺈزاﻟﺔ‬.‫ارﺗِﺪ اﻟﻘﻔﺎزات اﻟﺘﻲ ﺗﺴﺘﺨﺪم ﻟﻤﺮة واﺣﺪة‬
‫ﺗﻤﻨﻊ اﻟﻘﻔﺎزات ﻣﻼﻣﺴﺔ اﻟﺪم وﺳﻮاﺋﻞ اﻟﺠﺴﻢ واﻟﻜﺎﺋﻨﺎت‬
‫اﻟﻄﺮف اﻟﻤﻄﻮي ﻟﻠﺤﻘﯿﺒﺔ ﻷﻋﻠﻰ ﻣﺜﻞ اﻟﻜﻔﺔ‬
‫ ﯾﻤﻨﻊ ﺗﻜﻮﯾﻦ اﻟﻤﻄﻮق ﻗﺒﻞ ﺗﻔﺮﯾﻐﮫ اﻟﻤﺰﯾﺪ‬.‫اﻟﺤﯿﺔ اﻟﺪﻗﯿﻘﺔ‬
.‫ﻣﻦ اﻻﺗﺴﺎخ واﻟﺮاﺋﺤﺔ‬
5. Empty contents into bedpan, toilet, or Appliances do not need rinsing because
measuring device. rinsing may reduce appliance’s odor barrier.
‫ﻗﻢ ﺑﺈﻓﺮاغ اﻟﻤﺤﺘﻮﯾﺎت ﻓﻲ ﻏﻄﺎء اﻟﺴﺮﯾﺮ أو‬
Drying the lower section of the appliance
.‫اﻟﻤﺮﺣﺎض أو ﺟﮭﺎز اﻟﻘﯿﺎس‬
rem oves any additional fecal m aterial, thus
decreasing odor problems.
‫ﻻ ﺗﺤﺘﺎج اﻷﺟﮭﺰة إﻟﻰ اﻟﺸﻄﻒ ﻷن اﻟﺸﻄﻒ ﻗﺪ ﯾﻘﻠﻞ ﻣﻦ ﺣﺎﺟﺰ‬
.‫اﻟﺮواﺋﺢ ﻓﻲ اﻟﺠﮭﺎز‬

‫ﯾﺆدي ﺗﺠﻔﯿﻒ اﻟﺠﺰء اﻟﺴﻔﻠﻲ ﻣﻦ اﻟﺠﮭﺎز إﻟﻰ إزاﻟﺔ‬

.‫ وﺑﺎﻟﺘﺎﻟﻲ ﺗﻘﻠﯿﻞ ﻣﺸﺎﻛﻞ اﻟﺮاﺋﺤﺔ‬، ‫أي ﺑﺮاز إﺿﺎﻓﻲ‬
 Wipe the lower 2 inches of the applianceor
pouch with toilet tissue
‫ ﺑﻮﺻﺔ ﻣﻦ اﻟﺠﮭﺎز أو‬2 ‫اﻣﺴﺢ اﻟﺠﺰء اﻟﺴﻔﻠﻲ‬
‫اﻟﺤﻘﯿﺒﺔ ﺑﻤﻨﺪﯾﻞ اﻟﻤﺮﺣﺎض‬
6. Uncuff edge of appliance or pouch and
apply clip or clamp, or secure Velcro
closure. Ensure the curve of the clamp
follows the curve of the patient’s body.
Remove gloves. Assist patient to a
comfortable position.
‫ﻗﻢ ﺑﻔﻚ ﺣﺎﻓﺔ اﻟﺠﮭﺎز أو اﻟﺤﻘﯿﺒﺔ وﻗﻢ ﺑﺘﻄﺒﯿﻖ‬
.‫ أو إﻏﻼق اﻟﻔﯿﻠﻜﺮو ﺑﺈﺣﻜﺎم‬، ‫ﻣﺸﺒﻚ أو ﻣﺸﺒﻚ‬
‫ﺗﺄﻛﺪ ﻣﻦ أن ﻣﻨﺤﻨﻰ اﻟﻤﺸﺒﻚ ﯾﺘﺒﻊ ﻣﻨﺤﻨﻰ ﺟﺴﻢ‬
‫ ﻣﺴﺎﻋﺪة اﻟﻤﺮﯾﺾ‬.‫ اﻧﺰع اﻟﻘﻔﺎزات‬.‫اﻟﻤﺮﯾﺾ‬
.‫ﻓﻲ وﺿﻊ ﻣﺮﯾﺢ‬
7. If appliance is not to be changed, remove
additional PPE, if used. Perform hand
‫ ﻓﻘﻢ ﺑﺈزاﻟﺔ ﻣﻌﺪات‬، ‫إذا ﻟﻢ ﯾﺘﻢ ﺗﻐﯿﯿﺮ اﻟﺠﮭﺎز‬
.‫ إذا ﺗﻢ اﺳﺘﺨﺪاﻣﮭﺎ‬، ‫اﻟﺤﻤﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ اﻹﺿﺎﻓﯿﺔ‬
‫أداء اﻟﯿﺪ‬
Page 86
The edge of the appliance or pouch should
remain clean. The clamp secures closure. Hand
hygiene deters spread of microorganisms.
Ensures patient comfort.
‫ اﻟﻤﺸﺒﻚ ﯾﺆﻣﻦ‬.‫ﯾﺠﺐ أن ﺗﻈﻞ ﺣﺎﻓﺔ اﻟﺠﮭﺎز أو اﻟﺤﻘﯿﺒﺔ ﻧﻈﯿﻔﺔ‬
.‫ ﺗﻤﻨﻊ ﻧﻈﺎﻓﺔ اﻟﯿﺪﯾﻦ اﻧﺘﺸﺎر اﻟﻜﺎﺋﻨﺎت اﻟﺤﯿﺔ اﻟﺪﻗﯿﻘﺔ‬.‫اﻹﻏﻼق‬
.‫ﯾﻀﻤﻦ راﺣﺔ اﻟﻤﺮﯾﺾ‬
Removing PPE properly reduces the risk for
infection transmission and contamination ofother
items. Hand hygiene prevents the spread of
microorganisms.
‫ﺗﻘﻠﻞ إزاﻟﺔ ﻣﻌﺪات اﻟﻮﻗﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ ﺑﺸﻜﻞ ﺻﺤﯿﺢ ﻣﻦ‬
‫ ﺗﻤﻨﻊ‬.‫ﺧﻄﺮ اﻧﺘﻘﺎل اﻟﻌﺪوى وﺗﻠﻮث اﻟﻌﻨﺎﺻﺮ اﻷﺧﺮى‬
.‫ﻧﻈﺎﻓﺔ اﻟﯿﺪﯾﻦ اﻧﺘﺸﺎر اﻟﻜﺎﺋﻨﺎت اﻟﺪﻗﯿﻘﺔ‬
 hygiene.

8. CHANGING AN APPLIANCE:

Place a disposable pad on the work surface.
Set up the wash basin with warmwater and the
rest of the supplies. Place a trash bag within
reach.
:‫ﺗﻐﯿﯿﺮ اﻟﺠﮭﺎز‬
Protects the bed surface from contamination.
Organization of equipmentsfacilitates
performance of procedure.
‫ ﺗﻨﻈﯿﻢ اﻟﻤﻌﺪات‬.‫ﯾﺤﻤﻲ ﺳﻄﺢ اﻟﺴﺮﯾﺮ ﻣﻦ اﻟﺘﻠﻮث‬
.‫ﯾﺴﮭﻞ أداء اﻹﺟﺮاء‬

‫ ﻗﻢ‬.‫ﺿﻊ ﺿﻤﺎدة ﯾﻤﻜﻦ اﻟﺘﺨﻠﺺ ﻣﻨﮭﺎ ﻋﻠﻰ ﺳﻄﺢ اﻟﻌﻤﻞ‬

.‫ﺑﺈﻋﺪاد ﺣﻮض اﻟﻐﺴﯿﻞ ﺑﺎﻟﻤﺎء اﻟﺪاﻓﺊ وﺑﻘﯿﺔ اﻟﻤﺴﺘﻠﺰﻣﺎت‬
.‫ﺿﻊ ﻛﯿﺲ ﻗﻤﺎﻣﺔ ﻓﻲ ﻣﺘﻨﺎول اﻟﯿﺪ‬

9. Put on clean gloves. Place waterproof pad
under the patient at the stoma site.Empty the
appliance as described previously.
‫ ﺿﻊ ﺿﻤﺎدة ﻣﻘﺎوﻣﺔ ﻟﻠﻤﺎء ﺗﺤﺖ‬.‫ارﺗِﺪ ﻗﻔﺎزات ﻧﻈﯿﻔﺔ‬
‫ وأﻓﺮغ اﻟﺠﮭﺎز ﻛﻤﺎ ھﻮ‬، ‫اﻟﻤﺮﯾﺾ ﻓﻲ ﻣﻮﻗﻊ اﻟﻔﻐﺮة‬
.‫ﻣﻮﺻﻮف ﺳﺎﺑﻘًﺎ‬
Protects the bed linens and patient from moisture.
Emptying the contents before removal prevents
accidental spillage of fecalmaterial.
‫ ﯾﺆدي ﺗﻔﺮﯾﻎ‬.‫ﯾﺤﻤﻲ أﻏﻄﯿﺔ اﻟﺴﺮﯾﺮ واﻟﻤﺮﯾﺾ ﻣﻦ اﻟﺮطﻮﺑﺔ‬
‫اﻟﻤﺤﺘﻮﯾﺎت ﻗﺒﻞ اﻹزاﻟﺔ إﻟﻰ ﻣﻨﻊ اﻻﻧﺴﻜﺎب اﻟﻌﺮﺿﻲ ﻟﻠﻤﻮاد‬
.‫اﻟﺒﺮازﯾﺔ‬

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10. Gently remove pouch faceplate from skinby
pushing skin from appliance rather than
pulling appliance from skin. Start at the top of
the appliance, while keeping the abdominal
skin taut. Apply a silicone-based adhesive
remover by spraying or wiping with the
remover wipe.
‫ﻗﻢ ﺑﺈزاﻟﺔ ﻟﻮﺣﺔ واﺟﮭﺔ اﻟﺤﻘﯿﺒﺔ ﺑﺮﻓﻖ ﻣﻦ اﻟﺠﻠﺪ ﻋﻦ‬
‫طﺮﯾﻖ دﻓﻊ اﻟﺠﻠﺪ ﻣﻦ اﻟﺠﮭﺎز ﺑﺪﻻً ﻣﻦ ﺳﺤﺐ اﻟﺠﮭﺎز ﻣﻦ‬
‫ ﻣﻊ اﻟﺤﻔﺎظ‬، ‫ اﺑﺪأ ﻣﻦ اﻟﺠﺰء اﻟﻌﻠﻮي ﻣﻦ اﻟﺠﮭﺎز‬.‫اﻟﺠﻠﺪ‬
‫ ﺿﻊ ﻣﺰﯾﻞ اﻟﻼﺻﻖ ذو‬.‫ﻋﻠﻰ ﺟﻠﺪ اﻟﺒﻄﻦ ﻣﺸﺪودًا‬
‫اﻷﺳﺎس اﻟﺴﯿﻠﯿﻜﻮﻧﻲ ﻋﻦ طﺮﯾﻖ اﻟﺮش أو اﻟﻤﺴﺢ ﺑﻤﺴﺤﺔ‬
.‫اﻟﻤﺰﯾﻞ‬
The seal between the surface of the faceplate and
the skin must be broken before the faceplate can
be removed. Harshhandling of the appliance can
damage the skin and impair the development of a
secureseal in the future. Silicone-based adhesive
remover allows for the rapid and painless
removal of adhesives and prevents skin stripping.
‫ﯾﺠﺐ ﻛﺴﺮ اﻟﺨﺘﻢ ﺑﯿﻦ ﺳﻄﺢ اﻟﻠﻮﺣﺔ اﻷﻣﺎﻣﯿﺔ واﻟﺠﻠﺪ ﻗﺒﻞ‬
‫ ﯾﻤﻜﻦ أن ﯾﺆدي اﻻﺳﺘﺨﺪام اﻟﻘﺎﺳﻲ‬.‫إزاﻟﺔ اﻟﻠﻮﺣﺔ اﻷﻣﺎﻣﯿﺔ‬
‫ﻟﻠﺠﮭﺎز إﻟﻰ إﺗﻼف اﻟﺠﻠﺪ وإﻋﺎﻗﺔ ﺗﻄﻮﯾﺮ ﺧﺘﻢ آﻣﻦ ﻓﻲ‬
‫ ﯾﺴﻤﺢ ﻣﺰﯾﻞ اﻟﻼﺻﻖ اﻟﻘﺎﺋﻢ ﻋﻠﻰ اﻟﺴﯿﻠﯿﻜﻮن‬.‫اﻟﻤﺴﺘﻘﺒﻞ‬
‫ﺑﺈزاﻟﺔ ﺳﺮﯾﻌﺔ وﻏﯿﺮ ﻣﺆﻟﻤﺔ ﻟﻠﻤﻮاد اﻟﻼﺻﻘﺔ وﯾﻤﻨﻊ ﺗﺠﺮﯾﺪ‬
.‫اﻟﺠﻠﺪ‬

11. Place the appliance in the trash bag, if Thorough cleaning and airing of the appliance
disposable. If reusable, set aside to wash in reduce odor and deterioration of appliance. For
lukewarm soap and water and allow toair dry esthetic and infection-controlpurposes, discard
after the new appliance is in place. used appliances appropriately.
‫ إذا ﻛﺎن ﯾﻤﻜﻦ اﻟﺘﺨﻠﺺ‬، ‫ﺿﻊ اﻟﺠﮭﺎز ﻓﻲ ﻛﯿﺲ اﻟﻘﻤﺎﻣﺔ‬ ‫ﯾﺆدي اﻟﺘﻨﻈﯿﻒ واﻟﺘﮭﻮﯾﺔ اﻟﺸﺎﻣﻼن ﻟﻠﺠﮭﺎز إﻟﻰ ﺗﻘﻠﯿﻞ‬
ً ‫ اﺗﺮﻛﮫ ﺟﺎﻧﺒﺎ‬، ‫ إذا ﻛﺎن ﻗﺎﺑﻼً ﻹﻋﺎدة اﻻﺳﺘﺨﺪام‬.‫ﻣﻨﮫ‬ ‫ ﻟﻸﻏﺮاض اﻟﺘﺠﻤﯿﻠﯿﺔ‬.‫اﻟﺮاﺋﺤﺔ وﺗﺪھﻮر ﺣﺎﻟﺔ اﻟﺠﮭﺎز‬
‫ﻟﻐﺴﻠﮫ ﺑﺎﻟﻤﺎء واﻟﺼﺎﺑﻮن اﻟﻔﺎﺗﺮ واﺗﺮﻛﮫ ﯾﺠﻒ ﺑﻌﺪ وﺿﻊ‬ ‫ ﺗﺨﻠﺺ ﻣﻦ اﻷﺟﮭﺰة اﻟﻤﺴﺘﺨﺪﻣﺔ‬، ‫وﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى‬
.‫اﻟﺠﮭﺎز اﻟﺠﺪﯾﺪ ﻓﻲ ﻣﻜﺎﻧﮫ‬ .‫ﺑﺸﻜﻞ ﻣﻨﺎﺳﺐ‬

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 12. Use toilet tissue to remove any excess stool
from stoma. Cover stoma with gauze pad.
Clean skin around stoma with mild soap and
water or a cleansing agent and a washcloth.
Remove all old adhesivefrom skin; use an
adhesive remover, as necessary. Do not apply
lotion to peristomal area.
.‫اﺳﺘﺨﺪم ﻣﻨﺎدﯾﻞ اﻟﺤﻤﺎم ﻹزاﻟﺔ أي ﺑﺮاز زاﺋﺪ ﻣﻦ اﻟﻔﻐﺮة‬
‫ ﻧﻈﻒ اﻟﺠﻠﺪ ﺣﻮل اﻟﺜﻐﺮة‬.‫ﺗﻐﻄﯿﺔ اﻟﻔﻐﺮة ﺑﻀﻤﺎدة ﺷﺎش‬
‫ إزاﻟﺔ‬.‫ﺑﺼﺎﺑﻮن ﺧﻔﯿﻒ وﻣﺎء أو ﻋﺎﻣﻞ ﻣﻨﻈﻒ وﻣﻨﺸﻔﺔ‬
‫ﺟﻤﯿﻊ اﻟﻤﻮاد اﻟﻼﺻﻘﺔ اﻟﻘﺪﯾﻤﺔ ﻣﻦ اﻟﺠﻠﺪ ؛ اﺳﺘﺨﺪم ﻣﺰﯾﻞ‬
‫ ﻻ ﺗﻀﻊ اﻟﻤﺴﺘﺤﻀﺮ‬.‫ ﺣﺴﺐ اﻟﻀﺮورة‬، ‫اﻟﻤﻮاد اﻟﻼﺻﻘﺔ‬
.‫ﻋﻠﻰ ﻣﻨﻄﻘﺔ اﻟﺘﻤﻌﺞ‬
13. Gently pat area dry. Make sure skin around
stoma is thoroughly dry. Assess stoma and
condition of surrounding skin.
‫ ﺗﺄﻛﺪ ﻣﻦ ﺟﻔﺎف اﻟﺠﻠﺪ ﺣﻮل‬.‫ﺟﻔﻒ اﻟﻤﻨﻄﻘﺔ ﺑﻠﻄﻒ‬
.‫ ﺗﻘﯿﯿﻢ اﻟﻔﻐﺮة وﺣﺎﻟﺔ اﻟﺠﻠﺪ اﻟﻤﺤﯿﻂ‬.‫اﻟﺜﻐﺮة ﺗﻤﺎًﻣﺎ‬
14. Apply skin protectant to a 2-inch (5 cm)
radius around the stoma, and allow it to
2 ‫ﺿﻊ واﻗﻲ اﻟﺠﻠﺪ ﻋﻠﻰ داﺋﺮة ﻧﺼﻒ ﻗﻄﺮھﺎ‬
‫ ﺳﻢ( ﺣﻮل اﻟﻔﺘﺤﺔ واﺗﺮﻛﮭﺎ‬5) ‫ﺑﻮﺻﺔ‬
Page 89
Toilet tissue, used gently, will not damage the
stoma. The gauze absorbs any drainage from the
stoma while the skin is being prepared. Cleaning
the skin removes excretions and old adhesive and
skin protectant. Excretions or a buildup of other
substances can irritate and damage the skin.
Lotion will prevent a tight adhesive seal.
‫ ﯾﻤﺘﺺ اﻟﺸﺎش‬.‫اﺳﺘﺨﺪام ﻣﻨﺎدﯾﻞ اﻟﺤﻤﺎم ﺑﺮﻓﻖ ﻟﻦ ﯾﺘﻠﻒ اﻟﻔﺘﺤﺔ‬
‫ ﺗﻨﻈﯿﻒ اﻟﺠﻠﺪ‬.‫أي ﺗﺼﺮﯾﻒ ﻣﻦ اﻟﻔﻐﺮة أﺛﻨﺎء ﺗﺤﻀﯿﺮ اﻟﺠﻠﺪ‬
‫ ﯾﻤﻜﻦ‬.‫ﯾﺰﯾﻞ اﻹﻓﺮازات واﻟﻤﻮاد اﻟﻼﺻﻘﺔ اﻟﻘﺪﯾﻤﺔ وواﻗﻲ اﻟﺠﻠﺪ‬
‫أن ﺗﺆدي اﻹﻓﺮازات أو ﺗﺮاﻛﻢ اﻟﻤﻮاد اﻷﺧﺮى إﻟﻰ ﺗﮭﯿﺞ اﻟﺠﻠﺪ‬
.‫وإﺗﻼﻓﮫ‬
.‫ﺳﻮف ﯾﻤﻨﻊ اﻟﻤﺴﺘﺤﻀﺮ ﺧﺘﻢ ﻻﺻﻖ ﻣﺤﻜﻢ‬
Careful drying prevents trauma to skin and
stoma. Properly applied urinary collection device
protects skin integrity. Any change incolor and
size of the stoma may indicate circulatory
problems.
.‫اﻟﺘﺠﻔﯿﻒ اﻟﺪﻗﯿﻖ ﯾﻤﻨﻊ اﻟﺼﺪﻣﺎت اﻟﺘﻲ ﺗﻠﺤﻖ ﺑﺎﻟﺠﻠﺪ واﻟﻔُْﻐﺮة‬
‫ﺟﮭﺎز ﺟﻤﻊ اﻟﺒﻮل اﻟﻤﻄﺒﻖ ﺑﺸﻜﻞ ﺻﺤﯿﺢ ﯾﺤﻤﻲ ﺳﻼﻣﺔ‬
‫ ﻗﺪ ﯾﺸﯿﺮ أي ﺗﻐﯿﯿﺮ ﻓﻲ ﻟﻮن وﺣﺠﻢ اﻟﻔﻐﺮة إﻟﻰ ﻣﺸﺎﻛﻞ‬.‫اﻟﺠﻠﺪ‬
.‫ﻓﻲ اﻟﺪورة اﻟﺪﻣﻮﯾﺔ‬
The skin needs protection from the
excoriating effect of the excretion and
appliance adhesive. The skin must be
‫ﯾﺤﺘﺎج اﻟﺠﻠﺪ إﻟﻰ اﻟﺤﻤﺎﯾﺔ ﻣﻦ اﻟﺘﺄﺛﯿﺮ اﻟﻤﻔﺮط‬
‫ ﯾﺠﺐ أن‬.‫ﻟﻺﻓﺮاز واﻟﻤﻮاد اﻟﻼﺻﻘﺔ ﻟﻠﺠﮭﺎز‬
‫ﯾﻜﻮن اﻟﺠﻠﺪ‬
 dry completely, which takes about 30 perfectly dry before the appliance is placed to get
seconds. good adherence and to prevent leaks.
.‫ ﺛﺎﻧﯿﺔ‬30 ‫ وﯾﺴﺘﻐﺮق ذﻟﻚ ﺣﻮاﻟﻲ‬، ‫ﯾﺠﻒ ﺗﻤﺎًﻣﺎ‬ ‫ﯾﺠﻒ ﺗﻤﺎًﻣﺎ ﻗﺒﻞ وﺿﻊ اﻟﺠﮭﺎز ﻟﻠﺤﺼﻮل ﻋﻠﻰ اﻟﺘﺼﺎق ﺟﯿﺪ‬
.‫وﻟﻤﻨﻊ اﻟﺘﺴﺮﺑﺎت‬

15. Lift the gauze squares for a moment and The appliance should fit snugly around the
measure the stoma opening, using the stoma, with only 1/8 inch of skin visible
measurement guide. Replace the around the opening. Afaceplate

gauze. Trace the same-size opening on the

back center of the appliance. Cut theopening
1/8 inch larger than the stoma size. opening that is too small can cause traumato the
stoma. If the opening is too large, exposed skin
‫ارﻓﻊ ﻣﺮﺑﻌﺎت اﻟﺸﺎش ﻟﻠﺤﻈﺔ وﻗﻢ ﺑﻘﯿﺎس ﻓﺘﺤﺔ اﻟﻔﻐﺮة‬
will be irritated by stool.
‫ ﺗﺘﺒﻊ اﻟﻔﺘﺤﺔ‬.‫ اﺳﺘﺒﺪل اﻟﺸﺎش‬.‫ﺑﺎﺳﺘﺨﺪام دﻟﯿﻞ اﻟﻘﯿﺎس‬
‫ ﺑﺤﯿﺚ ﻻ ﯾﻈﮭﺮ‬، ‫ﯾﺠﺐ أن ﯾﻜﻮن اﻟﺠﮭﺎز ﻣﺤﻜًﻤﺎ ﺣﻮل اﻟﻔﺘﺤﺔ‬
‫ذات اﻟﺤﺠﻢ ﻧﻔﺴﮫ ﻓﻲ ﻣﻨﺘﺼﻒ اﻟﺠﺰء اﻟﺨﻠﻔﻲ ﻣﻦ‬
.‫ ﺑﻮﺻﺔ ﻣﻦ اﻟﺠﻠﺪ ﺣﻮل اﻟﻔﺘﺤﺔ‬8/1 ‫ﺳﻮى‬
.‫ ﺑﻮﺻﺔ أﻛﺒﺮ ﻣﻦ ﺣﺠﻢ اﻟﻔﻐﺮة‬8/1 ‫ ﻗﻄﻊ ﻓﺘﺢ‬.‫اﻟﺠﮭﺎز‬

.‫اﻟﻔﺘﺤﺔ اﻟﺼﻐﯿﺮة ﺟﺪًا ﯾﻤﻜﻦ أن ﺗﺴﺒﺐ ﺻﺪﻣﺔ ﻓﻲ اﻟﻔﻐﺮة‬

‫ ﻓﺴﻮف ﯾﺘﮭﯿﺞ اﻟﺠﻠﺪ‬، ‫إذا ﻛﺎﻧﺖ اﻟﻔﺘﺤﺔ ﻛﺒﯿﺮة ﺟﺪًا‬
.‫اﻟﻤﻜﺸﻮف ﺑﺴﺒﺐ اﻟﺒﺮاز‬
16. Remove the backing from the appliance. The appliance is effective only if it is properly
Quickly remove the gauze squares and ease positioned and adhered securely.
the appliance over the stoma. ‫اﻟﺠﮭﺎز ﻓﻌﺎل ﻓﻘﻂ إذا ﺗﻢ وﺿﻌﮫ ﺑﺸﻜﻞ ﺻﺤﯿﺢ وﻟﺼﻘﮫ‬
Gently press onto the skin while smoothing .‫ﺑﺈﺣﻜﺎم‬
over the surface. Apply gentlepressure to
appliance for 5 minutes.
‫ ﻗﻢ ﺑﺈزاﻟﺔ ﻣﺮﺑﻌﺎت اﻟﺸﺎش‬.‫ﻗﻢ ﺑﺈزاﻟﺔ اﻟﻐﻄﺎء ﻣﻦ اﻟﺠﮭﺎز‬
.‫ﺑﺴﺮﻋﺔ وﺧﻔﻒ اﻟﺠﮭﺎز ﻓﻮق اﻟﻔﺘﺤﺔ‬
‫ ﺿﻊ‬.‫اﺿﻐﻂ ﺑﺮﻓﻖ ﻋﻠﻰ اﻟﺠﻠﺪ ﻣﻊ ﺗﻨﻌﯿﻢ اﻟﺴﻄﺢ‬
ً ‫ﺿﻐ‬
.‫ دﻗﺎﺋﻖ‬5 ‫ﻄﺎ ﻟﻄﯿﻔًﺎ ﻋﻠﻰ اﻟﺠﮭﺎز ﻟﻤﺪة‬

Page 90
17. Close bottom of appliance or pouch by
folding the end upward and using the clamp
or clip that comes with the product, or secure
Velcro closure. Ensurethe curve of the clamp
follows the curve of the patient’s body.
‫أﻏﻠﻖ اﻟﺠﺰء اﻟﺴﻔﻠﻲ ﻣﻦ اﻟﺠﮭﺎز أو اﻟﺤﻘﯿﺒﺔ ﻋﻦ طﺮﯾﻖ‬
‫طﻲ اﻟﻨﮭﺎﯾﺔ ﻷﻋﻠﻰ واﺳﺘﺨﺪام اﻟﻤﺸﺒﻚ أو اﻟﻤﺸﺒﻚ اﻟﺬي‬
‫ ﺗﺄﻛﺪ ﻣﻦ‬.‫ أو إﻏﻼق اﻟﻔﯿﻠﻜﺮو ﺑﺈﺣﻜﺎم‬، ‫ﯾﺄﺗﻲ ﻣﻊ اﻟﻤﻨﺘﺞ‬
.‫أن ﻣﻨﺤﻨﻰ اﻟﻤﺸﺒﻚ ﯾﺘﺒﻊ ﻣﻨﺤﻨﻰ ﺟﺴﻢ اﻟﻤﺮﯾﺾ‬
18. Remove gloves. Assist the patient to a
comfortable position. Cover the patientwith
bed linens. Place the bed in the lowest
position.
.‫ ﺳﺎﻋﺪ اﻟﻤﺮﯾﺾ ﻓﻲ وﺿﻊ ﻣﺮﯾﺢ‬.‫اﻧﺰع اﻟﻘﻔﺎزات‬
‫ ﺿﻊ اﻟﺴﺮﯾﺮ‬.‫ﺗﻐﻄﯿﺔ اﻟﻤﺮﯾﺾ ﺑﺒﯿﺎﺿﺎت اﻟﺴﺮﯾﺮ‬
.‫ﻓﻲ أدﻧﻰ وﺿﻊ‬
19. P ut on clean gloves. R em ove or discard
equipment and assess patient’s responseto
procedure.
‫ ﻗﻢ ﺑﺈزاﻟﺔ أو اﻟﺘﺨﻠﺺ ﻣﻦ‬.‫ارﺗِﺪ ﻗﻔﺎزات ﻧﻈﯿﻔﺔ‬
.‫اﻟﻤﻌﺪات وﺗﻘﯿﯿﻢ اﺳﺘﺠﺎﺑﺔ اﻟﻤﺮﯾﺾ ﻟﻺﺟﺮاء‬
20. Remove gloves and additional PPE, if
used. Perform hand hygiene.
، ‫ﻗﻢ ﺑﺈزاﻟﺔ اﻟﻘﻔﺎزات وﻣﻌﺪات اﻟﻮﻗﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ اﻹﺿﺎﻓﯿﺔ‬
.‫ ﻗﻢ ﺑﻨﻈﺎﻓﺔ اﻟﯿﺪﯾﻦ‬.‫إذا ﺗﻢ اﺳﺘﺨﺪاﻣﮭﺎ‬
A tightly sealed appliance will not leak and
cause embarrassment and discomfort for the
patient.
‫ﻟﻦ ﯾﺘﺴﺮب اﻟﺠﮭﺎز اﻟﻤﺤﻜﻢ اﻹﻏﻼق وﯾﺴﺒﺐ اﻹﺣﺮاج‬
.‫وﻋﺪم اﻟﺮاﺣﺔ ﻟﻠﻤﺮﯾﺾ‬
Provides warmth and promotes comfort and
safety.
.‫ﯾﻮﻓﺮ اﻟﺪفء وﯾﻌﺰز اﻟﺮاﺣﺔ واﻷﻣﺎن‬
Gloves prevent contact with blood, body fluids,
and microorganisms that contaminatethe used
equipment. The patient’s response may indicate
acceptance of the ostomy as well as the need for
health teaching.
‫ﺗﻤﻨﻊ اﻟﻘﻔﺎزات ﻣﻼﻣﺴﺔ اﻟﺪم وﺳﻮاﺋﻞ اﻟﺠﺴﻢ واﻟﻜﺎﺋﻨﺎت‬
‫ ﻗﺪ ﺗﺸﯿﺮ‬.‫اﻟﺤﯿﺔ اﻟﺪﻗﯿﻘﺔ اﻟﺘﻲ ﺗﻠﻮث اﻟﻤﻌﺪات اﻟﻤﺴﺘﺨﺪﻣﺔ‬
‫اﺳﺘﺠﺎﺑﺔ اﻟﻤﺮﯾﺾ إﻟﻰ ﻗﺒﻮل اﻟﻔﻐﺮ وﻛﺬﻟﻚ اﻟﺤﺎﺟﺔ إﻟﻰ‬
.‫اﻟﺘﺪرﯾﺲ اﻟﺼﺤﻲ‬
Removing PPE properly reduces the risk for
infection transmission and contamination ofother
items. Hand hygiene prevents the spread of
microorganisms.
‫ﺗﻘﻠﻞ إزاﻟﺔ ﻣﻌﺪات اﻟﻮﻗﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ ﺑﺸﻜﻞ ﺻﺤﯿﺢ ﻣﻦ‬
‫ ﺗﻤﻨﻊ‬.‫ﺧﻄﺮ اﻧﺘﻘﺎل اﻟﻌﺪوى وﺗﻠﻮث اﻟﻌﻨﺎﺻﺮ اﻷﺧﺮى‬
.‫ﻧﻈﺎﻓﺔ اﻟﯿﺪﯾﻦ اﻧﺘﺸﺎر اﻟﻜﺎﺋﻨﺎت اﻟﺪﻗﯿﻘﺔ‬
 21. Document: To ensures continuity of care.
- Appearance of stoma, condition of .‫ﻟﻀﻤﺎن اﺳﺘﻤﺮارﯾﺔ اﻟﺮﻋﺎﯾﺔ‬
peristomal skin
:‫وﺛﯿﻘﺔ‬
‫ ﺣﺎﻟﺔ اﻟﺠﻠﺪ اﻟﺘﻤﮭﯿﺪي‬، ‫ ظﮭﻮر اﻟﺜﻐﺮة‬-

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