ColostomyColostomy is a surgical procedure that brings one end of the large intestine out through the abdominal wall. Stools moving through the intestine drain into a bag attached to the abdomen.
Description
The procedure is usually done after:
- Bowel blockage (obstruction)
- Bowel resection
- Injuries
Colostomy is done while you are under general anesthesia (asleep and pain-free). It may either be done with a large surgical cut in the abdomen, or with a small camera and several small cuts (laparoscopy).
The type of approach used depends on what other procedure done needs to be done. In general, the surgical cut is made in the middle of the abdomen. The bowel resection or repair is done as needed.
Nursing Care Plan for Colostomy
Sample Nursing Diagnosis for Colostomy
1. Risk for Impaired Skin Integrity : risk factors may include absence of sphincter at stoma and chemical irritation from caustic bowel contents, reaction to product/removal of adhesive, and improperly fitting appliance.
2. Risk for Diarrhea/Constipation : risk factors may include interruption/alteration of normal bowel function (placement of ostomy), changes in dietary/fluid intake, and effects of medication.*
3. Deficient Knowledge [Learning Need] regarding changes in physiologic function and self care/treatment needs may be related to lack of exposure/recall, information misinterpretation, possibly evidenced by questions, statement of concern, and inaccurate follow-through of instruction/development of preventable complications.
4. Disturbed Body Image may be related to biophysical changes (presence of stoma; loss of control of bowel elimination) and psychosocial factors (altered body structure, disease process/associated treatment regimen, e.g., cancer, colitis), possibly evidenced by verbalization of change in perception of self, negative feelings about body, fear of rejection/reaction of others, not touching/looking at stoma, and refusal to participate in care.
5. Impaired Social Interaction may be related to fear of embarrassing situation secondary to altered bowel control with loss of contents, odor, possibly evidenced by reduced participation and verbalized/observed discomfort in social situations.
6. Risk for Sexual Dysfunction: risk factors may include altered body structure/function, radical resection/treatment procedures, vulnerability/psychologic concern about response of SO(s), and disruption of sexual response pattern (e.g., erection difficulty)