Colostomy

Transverse colostomy
• Ileostomy - watery/ liquid
• ascending colon - watery/liquid
• transverse - mushy Ascending
colostomy
• descending - semi-formed
• sigmoid - well-formed / solid Descending
Color: & sigmoid
N - pink-red (beefy red) colostomy
An - blue, purple, dusky
N - slightly moist
- slight protrusion edema
- initially painful (post-op)
- painless
8@ - 3-5 days for the stoma to function
Diet: ⑧ Appliance: ·
• low fiber; low residue • 1/8 - 1/4 inch larger than the
stoma

Empty: 1/3 - 1/2 full ⑧

Change: 5-7 days
Using:
• vinegar
• sunlight
To prevent odor:
• charcoal
Run! • peppermint spray
Don't wait longer! • deodorizer
Let's empty!
Priority nursing dx?: colostomy
Safety zone A) risk for infection
B) fluid & electrolytes imbalance
C) impaired skin integrity
D) body image disturbance
 If pt has body image disturbance → he/she is in denial
Goal: acceptance
How to promote acceptance: Diet of colostomy ?
1) encourage verbalization of feelings (stoma) A) low fiber - ileostomy
2) encourage to visualize/ look @ stoma B) N diet
C) close to normal diet
3) encourage to touch & feel D) soft diet
4) stoma care - acceptance

No to:
°@· • gas/odor forming foods
1) broccoli 6) onions & garlic No to:
2) cauli flower 7) corn G - um
3) cabage 8) asparagus A - lcohol
4) mushroom 9) beans & nuts S - oda/smoking
5) egg 10) root crops

Recommend:
1) yogurt
2) crackers
3) parsley
4) butter milk
Avoided activities:
• contact sports
But swimming can be a
sport to them
 Colostomy irrigation

• for sigmoid & descending only

• to cleanse /regulate bowel
• to stimulate peristalsis
• sitting position; clean
technique
solution: lukewarm / tap water (500 - 1000 ml)
Height: 12 - 18 inches above stoma /shoulder level
Depth: 2 -4 inches (cone -tip catheter)
If cramps:
• stop by clamping
Double-barrel colostomy

Proximal
(Fecal)

Distal (mucus)