Hi guys let's talk about ostomy care, now this is
actually quite a bit of a bigger topic than you
might expect, you could see this anywhere from
pediatrics to adult patients so during this
presentation we're going to talk about what is an
ostomy, important nursing care that's needed for
those type of patients and also really important
skills to maintain it, so let's take a look.
So let's pause a minute on this slide, you may
say okay ostomy I haven't really heard of it why
is this even important but let's take a look
at this number this is pretty shocking to me.
So the number of people with ostomies in
the U.S. can range anywhere from 750,000
to 1 million, now that's a lot more honestly than
I even expected. The other thing to consider is
there around a hundred thousand new ostomy
surgeries each year, again that's a pretty
astonishing number if you sit and think about it.
Now most of these ostomy surgeries these could
be temporary and we're going to talk a little bit
about that later. So we just talked about how many
ostomies there can be out there, now let's take
a moment and talk about okay what is an ostomy ?
So if you take a look at the side with the patient,
you notice that there's a great illustration of
the patient's large intestine or if you remember
colon, so large intestine or colon, remember that.
The patient's large intestine if you remember is
going to be on the left side, so again let's go
back to this graphic so if you take a look at this
picture you're going to see an illustration of the
patient's large intestine here, you also see that
little pink circle that's something we're going to
talk about and focus on, so believe it or not in
this picture on this patient that you're seeing
that's actually a piece of the patient's large
intestine brought to the surface, yeah okay that
sounds a little weird I know but we're going
to get into this a little bit more as well.
So now let's take a look at the other illustration
with just the intestine itself and the pouch.
So if you're a member, the large intestine or
the colon is part of your digestive tract so
as part of your digestive tract of course stool or
feces is going to go through that right? So if you
see that little picture this pouch that you're
looking at, that's going to be there to catch it.
Now let's take a look at a great definition of
what is an ostomy, really the ostomy itself is just
a surgical opening and it's going to allow stool
or urine to leave the body, now you may wonder
okay how does a patient even get this? Well this
can occur if a patient has maybe colon or rectal
cancer for example, some sort of intestinal
blockage, trauma can cause it or if a patient has
like an abscess or inflammation or infection so
there's quite a bit of things that can happen here.
So let's pause to remember back we talked
about sometimes these can even be temporary
so what we mean by this is sometimes if you look
at this picture let me orient you to that, you see
all those little pouches or those little bubbles
you see on the large intestine, sometimes those
things can get inflamed or infected or there
could be issues here to where surgically we
have to remove part of that, so sometimes we create
an ostomy to allow the bowel to rest, recover
and then we can remove the ostomy and reattach
or redo another surgery so the patient does not
have to have that ostomy anymore. So again the
ostomy sometimes is created just allow the bowel
to rest surgically and then they can reverse
that so the patient does not need that anymore.
So we're talking about ostomies, really
it's you're going to know more about
that ostomy because they're named by their
location so that's really convenient for us
so if you take a look here on the colostomy
picture, if you remember, colon or large intestine
again there's that location for your colostomy is
going to be in that large intestine or the colon.
Now if you look here in the middle, the ileostomy
that's the last part of your small intestine
called the ilium so again that's the ileostomy,
so that's really helpful for us as nurses right.
So let's go back and talk about that anatomy
again so one thing is a nurse to expect between
the colostomy and the ileostomy, think about
your digestive process, now your clot your colon
is farther down in that digestive process so
you should see a little bit more form stool
here in the colostomy if the patient has that, now
higher up in the digestive process if you remember,
the small intestines a little bit higher up
there in that process so the stool coming out
of that is probably going to be a little bit more
liquid and soft, so that's a good comparison and
lastly look at the urostomy picture. So again
going back to that anatomy guys, you remember
those ureters are attached to the kidneys, so you
can take that ureter, bring it to the surface and
create an urostomy, so now what's going to come out
of that? Okay, urine is going to come out of that.
If you recall ostomies can remove either stool,
feces or urine out of the body. Okay so we just
talked about ostomies, now let's talk about what is
a stoma? You're probably thinking okay great,
here's another word here, but let's re-look
at this graphic that we looked at earlier
so if you see on the patient's side you see that
little pink circle, when we're talking about a
stoma this is what we're going to be paying
attention to. Also, if you take a look at the
other graphic of the large intestinal colon, you
see the pouch that's attached to the pink circle.
Well that pouch is what's going to go around
the stoma and catch any stool or feces here.
Now really the stoma is just the opening of
the abdomen and it looks like a small pinkish
circular piece of flesh, sounds kind of weird
right? But this is actually sewn to our body
and also know any time you see a patient's stoma,
it's going to vary just a little bit, it could be
kind of fairly flat to the body, it could protrude
out a little bit the size may differ just a little
bit, so just know you may see some variations here.
Now one key note before we leave, sometimes you
may in nursing report hear from another nurse, the
patient in 952 has a stoma or they have an ostomy.
You may kind of hear these words interchangeably,
so know that that just may come up for you.