What is a Urostomy?
A
urostomy is a surgical procedure that creates a stoma (artificial opening) for the urinary system. This is usually necessary when the bladder is either not functioning properly or has been removed due to conditions such as bladder cancer, severe trauma, or congenital defects. The stoma allows urine to bypass the bladder and exit the body through the abdominal wall.
Types of Urostomy
There are several types of urostomies, including
ileal conduit, ureterostomy, and
neobladder. The ileal conduit is the most common type, where a small section of the ileum is used to create a conduit for urine to pass from the ureters to an external stoma bag.
Preoperative Nursing Care
Preoperative care involves patient education and preparation. Nurses must:- Explain the procedure and its necessity.
- Discuss stoma site selection to ensure that it is in a location that the patient can easily manage.
- Provide emotional support and address any
concerns or anxieties.
- Ensure that the patient understands the postoperative care and lifestyle changes required.
Postoperative Nursing Care
Postoperative care is crucial for recovery and includes:- Monitoring vital signs and
assessing the stoma for color, size, and output.
- Teaching the patient and family about stoma care, including how to empty and change the urostomy bag.
- Ensuring that the patient is comfortable with managing the stoma independently before discharge.
- Monitoring for complications such as infection, skin irritation, or stoma blockage.
Stoma and Skin Care
Proper stoma and skin care are essential to prevent complications. Nurses should educate patients on the following:- Cleaning the stoma with warm water and mild soap.
- Ensuring the stoma appliance fits correctly to prevent leaks and skin irritation.
- Using stoma powder or paste to protect the skin around the stoma.
- Recognizing signs of
infection or skin breakdown, such as redness, swelling, or unusual discharge.
Addressing Complications
Several complications can arise from a urostomy, including:- Infection: Nurses must monitor for signs of infection and educate patients on proper hygiene.
- Stoma Prolapse: This occurs when the stoma protrudes too far from the abdomen. Immediate medical attention is required.
- Urinary Tract Infections (UTIs): Encourage patients to drink plenty of fluids and educate them on recognizing UTI symptoms like fever, foul-smelling urine, or back pain.
Emotional and Psychological Support
Adjusting to a urostomy can be challenging emotionally and psychologically. Nurses play a key role in offering support by:- Providing resources such as support groups or counseling services.
- Encouraging open communication about feelings and concerns.
- Reinforcing positive aspects of life post-urostomy, including the return to normal activities and improved quality of life.
Patient Education and Resources
Effective patient education includes:- Demonstrations and return demonstrations of stoma care.
- Providing written materials and resources for further reading.
- Connecting patients with
support groups and online forums for additional support and community.
Conclusion
Nurses play a vital role in the care and management of patients with urostomies. Through comprehensive preoperative and postoperative care, patient education, and ongoing emotional support, nurses can help patients adapt to their new lifestyle and maintain a high quality of life.
