What is an Ostomy?
An
ostomy is a surgically created opening in the body that allows for the discharge of bodily wastes. This opening, called a stoma, is often created in the abdominal wall, and it can be necessary due to conditions such as colorectal cancer, Crohn's disease, or traumatic injury. The waste is collected in an external pouching system.
Types of Ostomies
There are several types of ostomies, including: Colostomy: An opening from the colon.
Ileostomy: An opening from the ileum, part of the small intestine.
Urostomy: An opening that allows urine to exit the body bypassing the bladder.
Preoperative Care
Preoperative care is crucial for a patient undergoing ostomy surgery. Nurses must provide education about the procedure, potential lifestyle changes, and the necessary post-operative care. This includes discussing the management of the stoma and the use of ostomy appliances. Psychological support is also important to help the patient cope with the changes.Postoperative Care
Postoperative care involves regular monitoring and management of the stoma and the surrounding skin. Nurses should assess the stoma for color, size, and output to identify any complications early. Proper hygiene and correct fitting of the ostomy pouch are essential to prevent
skin irritation and infections.
Nutrition and Diet
Diet and nutrition play a significant role in ostomy management. Patients may need to adjust their diet to avoid foods that cause excessive gas, odor, or blockages. Nurses should provide dietary counseling and resources, including a referral to a dietitian if necessary, to ensure that patients maintain a balanced and manageable diet.Psychological Support
The psychological impact of an ostomy can be profound. Nurses must address the emotional and mental health needs of their patients. This can include providing resources for
support groups, offering counseling services, and encouraging open communication about concerns and fears related to the ostomy.
Complications and Management
Complications can arise from an ostomy, including
parastomal hernias, skin irritation, and stoma blockage. Nurses should be knowledgeable about these potential issues and prepared to provide appropriate interventions. Regular follow-up and patient education can help in early detection and management of these complications.
Patient Education
Patient education is a continuous process. Nurses should ensure that patients and their caregivers understand how to care for the stoma, including how to change the ostomy appliance, recognize signs of complications, and maintain a healthy lifestyle. Written materials and hands-on demonstrations can be very effective.Role of the Ostomy Nurse
Specialized ostomy nurses, or
Wound, Ostomy, and Continence Nurses (WOCNs), play a vital role in the care of ostomy patients. They provide expert care, support, and education, and are a critical resource for both patients and healthcare teams.
Conclusion
Nursing care for patients with an ostomy is multifaceted, requiring a combination of technical skills, patient education, and emotional support. By understanding and addressing the comprehensive needs of these patients, nurses can significantly improve their quality of life and overall health outcomes.
