what are stoma care teaching points?
Stoma color – should appear beefy and red Stomal membrane: Should be shiny and moist
Protrusion – normal stoma will only protrude slightly; is it flush, retracted, or protruding significantly outward?
Stoma output (amount and type) – normal is anywhere between 500 – 1000 mL each day (depends on type of stoma/location of stoma)
Peristomal skin – assess for signs of infection, excoriation, redness, etc.
Stoma size
Don’t forget to assess PQRSTU & psychosocial and psychological wellbeing
what nutritional teaching points for pt w ostomies?
Eat smaller more frequent meals throughout the day
Eat slowly and chew the food well
Drink 8 to 10 glasses of water each day
Avoid foods such as nuts, raw fruit skins, popcorn, and raison as they can potentially result in a blockage of the stoma
Avoid gas/odour producing foods (asparagus, broccoli, beer, alcohol, cabbage, corn, cauliflower, spicy foods, chewing gum, garlic, etc)
what teaching should you give abt changing/emptying ostomies?
in the morning when the gut is the least actively
empty when 1/3 full
The wafer should fit snug around stoma, 1/8” close to stoma
how do you prevent skin breakdowns w ostomies?
- Change appliance every 3 to 5 days
- Ensure right size of pouch/flange is used (too loose can
cause irritation to surrounding skin) - If there is burning or itching, the system needs to be
changed - Gently remove skin barrier from top to bottom – adhesive
remover may help - Clean peristomal skin with warm water
- Ensure soap is oil and residual free
- Ensure peristomal skin is dry
- Cover with a hydrocolloid wafer before applying the bag
- Apply skin barrier if needed
- Place a towel under stoma to prevent leakage onto healthy
skin
what are post op teaching points for ostomies?
- color
- consistency of stool
- how to mask odours
- signs of complications
- what the size should be
- when to empty
-Swimming in water max 30-60 min, change apparatus and
go back
When to Seek Medical Attention (ostomy)?
Fluid and electrolyte imbalance
Fever
Diarrhea
Constipation
Change in stoma appearance
Change in stoma function
Change in peristomal skin
