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Colostomy - Coggle Diagram

- - - - Alternative sexual positions
      - Alternative methods of stimulation
      - Use smaller pouches
      - To avoid irritant food that produce odor
- - - - Assess stoma bleeding
      - Assess status of peristomal skin
      - Assess size and shape of stoma
      - Assess amount and type of faeces
      - Assess stoma colour
      - Assess for complaints
      - Determine type & size of appliance, special barrier
      - Clients and family members learning needs re: ostomy self care; clients emotional needs e.g. body image
      - Determine type and location of stoma
    - - Clean and dry the peristomal skin and stoma
        
        Use toilet tissue to remove excess stool
        
        Clean skin using warm water and cotton/cloth
        
        Dry skin thoroughly by patting with towel
        
        Assess peristomal skin and stoma for changes in colour, size, shape and ulceration
      - Measure stoma size
        
        On the backing of the skin
        barrier, trace the measured pattern on pouch
        
        Cut pouch → opening
        should large enough (extra 2-3mm)
        
        Use guide to measure size
        of stoma
      - Remove pouch
        
        Remove the pouch slowly, begin at the top and work downward while holding the patient’s skin taut
        
        Dispose of bag in clinical waste bag
        
        Measure output if required
      - Apply one–piece pouching system
        
        Center and apply pouch to clean and dry skin
        
        Press the skin barrier against the skin
        
        Remove paper from outer ring
        
        Smooth the edges of adhesive to skin
        
        Ensure bag is lying at side of patient
      - Prepare patient
        
        Explain procedure and provide privacy
        
        Raise bed to high position
        
        Determine exact supplies client uses
        
        Wash hands and don gloves
        
        Check client care plan and identify correct client
        
        Place bath blanket over client, protective sheet under client
        
        Observe placement of stoma → amount & consistency
      - Apply two-piece pouch system
        
        Remove gauze over stoma before apply
        pouch
        
        Snap pouch onto the flange or skin barrier
        wafer
        
        Center the skin barrier over stoma and gently press it onto skin for 30 seconds
        
        Apply a ring of skin barrier paste to opening on pouch or stomahesive powder to denuded skin only
      - Close and secure end of pouch with tail closure
        
        Remove soiled pouch and gauze
        
        Remove gloves and wash hands
        
        Squeeze clamp together to close
        
        Position client to comfort
        
        Lay hook on top of bag and fold the back 2.5cm over end of pouch
        
        Return bed to low position
        
        Ensure bowed end is next to body
        
        Comfort the patient