From the Guidelines
A comprehensive care plan for a colostomy involves regular emptying of the pouch when it's one-third to one-half full, typically 1-3 times daily, and changing the entire appliance every 6 to 7 days, as recommended by the most recent clinical practice update on management of ostomies 1.
Key Components of Colostomy Care
- Regular emptying of the pouch to prevent leakage and skin irritation
- Changing the entire appliance every 6 to 7 days, or immediately if leakage occurs, to maintain skin health and prevent infection
- Cleaning the stoma and surrounding skin with warm water and mild soap, avoiding alcohol-based products which can dry the skin, as suggested by recent clinical guidelines 1
- Applying a skin barrier paste or powder if skin irritation develops to protect the skin and promote healing
- Monitoring the stoma for changes in color, size, or shape, and checking for skin complications like redness, rash, or breakdown to promptly address any issues
Dietary Recommendations and Lifestyle Adjustments
- Maintaining adequate hydration to help manage output consistency
- Following dietary recommendations to manage output consistency, typically avoiding high-fiber foods initially and gradually reintroducing them while monitoring their effects, as advised by recent clinical practice updates 1
- Emptying the pouch before physical activities to prevent leakage and discomfort
- Considering using pouch deodorizers to minimize odor and improve quality of life
Ongoing Care and Support
- Keeping extra supplies on hand, including pouches, skin barriers, and cleaning materials, to ensure continuity of care
- Regular follow-up with healthcare providers to address complications and adjust the care plan as needed, which is crucial for preventing complications like skin breakdown, infection, and improving quality of life by managing odor and leakage effectively, as emphasized by recent clinical guidelines 1
From the Research
Care Plan for a Patient with a Colostomy
The care plan for a patient with a colostomy involves several key components, including:
- Preoperative education and stoma site marking by a trained stomatherapist 2
- Selection of an appropriate ostomy pouching system 3
- Postoperative education on stoma care and management 4, 3
- Monitoring for and management of potential complications, such as peristomal skin complications, retraction, stomal necrosis, and parastomal hernia 5
- Follow-up care after discharge from the acute care setting to ensure ongoing support and management 3
Preoperative Care
Preoperative care for a patient with a colostomy includes:
- Education on the procedure and what to expect 4, 2
- Stoma site marking by a trained stomatherapist to ensure optimal placement 2
- Discussion of potential complications and how to manage them 5
Postoperative Care
Postoperative care for a patient with a colostomy includes:
- Education on stoma care and management, including how to change the ostomy pouching system 4, 3
- Monitoring for potential complications, such as bleeding, dehydration, and stomal stenosis 5
- Support and guidance on adapting to life with a colostomy, including emotional support and counseling 4, 3
Ongoing Management
Ongoing management of a patient with a colostomy includes:
- Regular follow-up appointments with a healthcare provider to monitor for potential complications and address any concerns 3
- Ongoing education and support on stoma care and management 4, 3
- Monitoring for and management of potential long-term complications, such as parastomal hernia and stomal necrosis 5