nursingcareofcolostomy分析.pptVIP

Nursing care of colostomy Preoperative inform 术前告知 the nurse assists the clients to prepare for colon resection by reinforcing the physician’s explanation of the planned surgical procedures. Before evaluating the tumor and colon in surgery, the physician might not be able to determine whether a temporary or a permanent colostomy will be necessary .if this is the case ,the physician informs the client that a colostomy is a possibility .when the physician is certain that a permanent colostomy will be necessary, the client is told about the colostomy before the surgery ,such as the rationales, place and care of colostomy. The client is told as accurately as possible what anatomic and physiologic changes will occur with surgery .the nurse consults an enterostomal therapist if available. Sexual dysfunction is a potential problem for men or women who undergo rectal surgery for cancer . the physician discusses this risk with the client, and the nurse supports the client in this concern. Postoperative care Colostomy care  Stoma location is an indicator of the section of bowel in which it is located and a predictor of the type of fecal drainage to expect . the consistency of drainage depends on the stoma location in the bowel. A colostomy in the ascending and transverse colon has semi-liquid stools. The client need to be instructed to use a drainable pouch. A colostomy in the sigmoid or descending colon has semiformed or formed stools and can sometimes be regulated by the irrigation method. The client may or may not wear a drainage pouch. A light pouch may be used for security. with an open-ended, transparent, plastic, odor-proof pouch, it is easy to protect the skin and to observe and collect the drainage. prior to discharge ,provide written, verbal, and psychomotor instruction on colostomy care, pouch management ,skin care, and irrigation for the client. Activities of daily living are resumed within 6-8weeks.heaving lifting should be avoided . bathing and