INTESTINAL OSTOMIES
An ostomy is a surgi cal opening completed on abdominal wa ll.
Purpose:
▪ Provides an al ternate feeding route.
▪ Elimi nate feces or urine.
Assessment:
1. Color: bright red
2. Size and shape
3. Bleeding
4. Peristomal skin
5. Amount and type of feces
Complications:
Fluids and electrolyte imbala nce
Infection
Constipation
Stomal prolapse or retraction
Skin Breakdown
Principles:
1. Assess stoma and peristomal ski n each time the appliance i s changed.
2. Report pale or dark-colored stoma and stomal bleeding.
3. Apply a barr ier (ex. Kara ya gum) over the skin ar ound the stoma to prevent contact with any
excretions.
4. Control odors:
A green l eafy vegetables
B ismuth
C harcoal
D eodorizer
☝
Remember:
• A void heavy lifting and contact sports.
• L axati ve and enemas m ay cause sever e fluid and electrolyte i mbalance.
Examples:
1. GASTROSTOMY- an opening through the abdominal wall into the stomach.
2. JEJUNOSTOMY- an opening through the abdominal wall i nto the jejunum.
3. ILEOSTOMY- an opening i n the ileum (small bowel) for draining feca l material s.
Watch out for breakdown of the skin.
Purpose: to treat granuloma tous, ulcerative colitis, reg ional enteri tis or divert intestinal contents in
colon CA, fam ilial polypsis, congenital defects, or trauma.
Ileostomy care:
▪ Principle of care: usually the same with colostomy.
▪ Ileostomy is never i rrigated.
▪ Initial discharged: liquid becomes semi-solid/ pasty
▪ Diet:
○ High calorie a nd proteins with vitamin a nd mineral supplements; fat restric tion may
be necessary.
○ Increase sal t intake
○ Restrict fi brous foods
○ Supplement fluids with beverages containing electrolytes and glucose.
Other Nursing Interventions:
▪ Monitor intake a nd output, including l iquid stools
▪ Weigh patient dai ly
▪ Monitor electrolytes and hematocrit
▪ Monitor blood for B12 l evels. Give replacem ent by injection.
▪ Contact sports must be avoided.
