Nursing Interventions for a Client with Ostomy; Additional Guidelines for Nursing Care

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  1. Empty pouches when they are about 1/3 to half full
  2. If needed, protect skin around ileostomy stoma
  3. Ostomies threaten body image. Do not force client to look at stoma.
  4. Fears of mutilation, shame, rejection are common
  5. Clients may feel powerless because they cannot fully control bodily functions
  6. Assist client to establish normal elimination routine. Observe client’s tolerance of colostomy irrigation; report immediately if:
    • Stoma oozes blood when touched
    • You see blood in pouch
    • You see bleeding from stoma
    • Urinary diversion puts out less than 30cc/hour
    • Urine smells foul
    • There is blood in urine, or it is very cloudy
    • Client reports burning sensation around base of urinary diversion stoma
    • Client reports back pain, chills, or fever
  7. Teach client
    • The types of equipment and their use
    • How to irrigate colostomy
    • Prevention of complications
    • How to avoid constipation
    • That it is vital to drink plenty of fluids

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