COLOSTOMY IRRIGATION – Purpose, Types of Colostomy, Solutions Used, Preliminary Assessment, Preparation of the Patient and the Environment, Preparation of the Article, Procedure and Post-Procedure Care
Colostomy irrigation is similar to an enema, in a form of stoma management used only for clients who have sigmoid colostomy or descending colostomy.
Colostomy is an operations in which artificial opening is made into the colons on the anterior abdominal wall to permit the escape of feces and flatus.
PURPOSE
- To establish regularity of evacuation
- To cleanse the intestinal tract of gas, mucus and feces
- To prevent excoriations of the skins around stoma
- To remove any irritant foods ingested by the patient
- To teach patient and his relatives the care of colostomy
TYPES OF COLOSTOMY
- Temporary and permanent colostomy
- Double-barreled colostomy and end-colostomy
- Wet colostomy and dry colostomy
SOLUTIONS USED FOR COLOSTOMY IRRIGATION
- Normal saline
- Plain water
- Soapy solutions
PRELIMINARY ASSESSMENT
- What is the name, bed number and other identification of the patient
- Check the diagnosis and purpose of irrigation
- Check the type of colostomy done. Make sure of the proximal and distal loop of the colors
- Check the patient’s ability for self-care
- Check the doctor’s order for specific instructions and the precautions, if any, regarding the colostomy irrigations, movement of the patient, etc
- Check the understanding of the patient to follow instructions
- Check the articles available in patient’s unit
PREPARATION OF THE PATIENT AND THE ENVIRONMENT
- Explain the procedure to the patient
- Make the patient sit on a chair in the bathroom. A rubber sheet placed on the lap of the patient can be used as a through leading into the toilet to receive returns flow
- Provide privacy. Remove undergarments
- Clean the skin around the stoma with clears cotton swabs or rag pieces
PREPARATION OF THE ARTICLE
- Irrigating can with tubing, clamp and catheter
- IV stand
- A jug with solution at the temp of 100-105 degree celcius
- Water soluble jelly
- Clean cotton swabs
- Kidney tray
- Dressing, protective ointments
- Mackintosh
- Clean linen
- Bucket
- Stoma bag
PROCEDURE
- Wash hands
- Fill the irrigating can with the solutions and hang it at a required height
- Expel the air from the tubing and clamp it remove the froth if any
- Unite colostomy bag and remove the dressing
- Introduce the catheter through the teat and the tip of the catheter is lubricated with water and jelly
- Pour some solutions over stoma
- Introduce catheter into stoma about 4 inches. Do not use any force
- Allow the solutions to pass slowly, involving about 20 minutes
- Clamp the tube before the entry of entire fluid
- Remove the catheter from stoma. Disconnect it from the tubing and place it in the kidney tray
- Wait for the return flow. Divert the attention of the patient
POST-PROCEDURE CARE
- When return flow is complete, remove the Mackintosh clean the skin around the colostomy opening of and dry use skin thoroughly
- Apply a clean dressing or a clear colostomy bag over the stoma
- Change the dressing of incision aspect technique
- Take all the articles in utility room. Clean the equipment immediately
- Patients are instructed for the care and support of colostomy bags to prolong its life and keep it free from odor
- Chart the procedure in the patient’s record
