When the client would have normally had a bowel movement
After the client accepts he had a bowel movement
Before breakfast and morning care
At least 2 hours before visitors arrive
Stops the flow of fluid when he feels uncomfortable
Lubricates the tip of the catheter before inserting it into the stoma
Hangs the bag on a clothes hook on the bathroom door during fluid insertion
Discontinues the insertion of fluid after only 500 ml of fluid has been instilled
Abdominal cramps during fluid inflow
Difficulty in inserting the irrigating tube
Passage of flatus during expulsion of feces
Inability to complete the procedure in half an hour
A reaction formation to his recent altered body image.
A difficult time accepting reality and is in a state of denial.
Impotency due to the surgery and needs sexual counseling
Suicide thoughts and should be seen by psychiatrist
Food low in fiber so that there is less stool
Everything he ate before the operation but will avoid those foods that cause gas
Bland foods so that his intestines do not become irritated
Soft foods that are more easily digested and absorbed by the large intestines
Body image, disturbed
Fear related to poor prognosis
Nutrition: more than body requirements, imbalanced
Notify the physician
Stop the irrigation temporarily
Increase the height of the irrigation
Medicate for pain and resume the irrigation
Increase fluid intake
Place heat on the abdomen
Perform the irrigation in the evening
Reduce the amount of irrigation solution
Destroys the odor-proof seal
Wont affect the colostomy system
Is appropriate for relieving the gas in a colostomy system
Destroys the moisture barrier seal
Enterostomal nurse therapist
Look at the ostomy site
Participate with the nurse in his daily ostomy care
Ask for leaflets and contact numbers of ostomy support groups
Talk about his ostomy openly to the nurse and friends
Plain NSS / Normal Saline
Ask to defer colostomy care to another individual
Promises he will begin to listen the next day
Agrees to look at the colostomy
States that colostomy care is the function of the nurse while he is in the hospital
Stop the irrigation by clamping the tube
Slow down the irrigation
Tell the client that cramping will subside and is normal
Notify the physician
A sunken and hidden stoma
A dusky and bluish stoma
A narrow and flattened stoma
Protruding stoma with swollen appearance
Eat beet greens and parsley
Eat broccoli and spinach
Use 500 ml to 1,000 ml NSS
Suspend the irrigant 45 cm above the stoma
Insert the cone 4 cm in the stoma
If cramping occurs, slow the irrigation
He experiences abdominal cramping while the irrigant is infusing
He has difficulty inserting the irrigation tube into the stoma
He expels flatus while the return is running out
He’s unable to complete the procedure in 1 hour
Call the doctor immediately.
Obtain an order to irrigate the stoma.
Place the patient on bed rest and call the doctor.
Continue the current plan of care.
After surgery, changes in activities must be made to accommodate for the physiologic changes caused by the operation.
Most sports activities, except for swimming, can be resumed based on the client’s overall physical condition.
With counseling and medical guidance, a near normal lifestyle, including complete sexual function is possible.
Activities of daily living should be resumed as quickly as possible to avoid depression and further dependency.
The surgery will temporarily decrease the client’s sexual impulses.
Sexual relationships must be curtailed for several weeks.
The partner should be told about the surgery before any sexual activity.
The client will be able to resume normal sexual relationships.
Proper functioning of nasogastric suction
Presurgical decrease in fluid intake
Absence of gastrointestinal motility
Intestinal edema following surgery
Is the opening on the client’s left side
Is the opening on the distal end on the client’s left side
Is the opening on the client’s right side
Is the opening on the distal right side
Hold the syringe 18 inches above the stoma and administer the feeding slowly
Pour 30 ml of water before and after feeding administration
Insert the ostomy feeding tube 1 inch towards the stoma
A Pink stoma means that circulation towards the stoma is all well
Keep the client NPO for 24 hrs before surgery
Administer neomycin sulfate the evening before surgery
Inform the client that total parenteral nutrition will likely be implemented after surgery
Advise the client to limit physical activity
"Your wife's need to help you is a reality you should accept"
"Do you think your wife might benefit from counseling?"
"You feel you need privacy when changing your colostomy?"
"Have you discussed the situation with your doctor?"
The skin wasn’t lubricated before the pouch was applied.
The pouch faceplate doesn’t fit the stoma.
A skin barrier was applied properly.
Stoma dilation wasn’t performed.