Ostomy Care

Types of Ostomies
■ Colostomy: May be permanent or temporary. Used when only part of large intestine is removed. Commonly placed in sigmoid colon, stoma is made from large intestine and is larger in appearance than an ileostomy. Contents range from firm to fully formed, depending on amount of remaining colon.

■ Ileostomy: May be permanent or temporary. Used when entire large intestine must be removed. Stoma is made from small intestine and is therefore smaller than that of a colostomy. Contents range from paste-like
to watery.

■ Urostomy: Used when urinary bladder is either bypassed or must be removed altogether.

Procedure for Changing an Ostomy Bag
■ Explain procedure to Pt.
■ Gather supplies.
■ Place Pt in supine position.
■ Wash hands and observe standard precautions (don gloves).
■ Remove old pouch by gently pulling away from skin.
■ Discard gloves, wash hands, and don new pair of gloves.
■ Gently wash area around stoma with warm, soapy water, and then dry skin thoroughly.
■ Inspect appearance of the stoma and condition of skin, and note amount, color, consistency of contents, and presence of unusual odor (note: normal-looking stoma should be pink-red, and peristomal skin should be free from any redness or ulceration).
■ Cover exposed stoma with gauze pad to absorb any drainage during ostomy care.
■ Apply skin prep in circular motion and allow to air dry for approximately 30 seconds.
■ Apply skin barrier in circular motion.
■ Measure stoma using stoma guide and cut ring to size.
■ Remove paper backing from adhesive-backed ring, and, using gentle pressure, center ring over stoma and press it to skin.
■ Smooth out any wrinkles to prevent seepage of effluent.
■ Center faceplate of bag over stoma and gently press down until completely closed.
■ Document appearance of the stoma, condition of skin, amount, color, and consistency of contents, and presence of any unusual odor.
■ Discard soiled items per hospital policy using standard precautions.