A new ostomy patient and caregiver have a lot to learn before discharge. Some crucial things to learn may include emptying a pouch, establishing a schedule to change the pouch, measuring the stoma to make sure that the skin barrier is protecting the skin from the effluent, and using other accessories appropriately. Emptying the pouch You will need to teach your patient or caregiver to empty the pouch when it is one-third to half full. Too much weight of the bag can cause it to get off the skin, which allows the leakage. Tell them that emptying the pouch is generally easier when it is not full. Ask the patient or caregiver to empty the pouch at least once before leaving the hospital. Modern-day pouches are odor-proof, so it is not necessary to rinse them. If the patient insists on rinsing the bag, tell them to instill water from the open end at the bottom. Getting water into the bag through the skin barrier’s opening can break down the barrier, making the pouching system unfit for further use. Schedule for pouch changes A patient needs to replace the existing drainable pouch with a new one every 3-5 days; but, it depends entirely on the stomal output, abdominal contours, and the situation of the peristomal skin. If the patient has to use a closed-end pouch, tell them to dispose of the pouch when it is half full. The patient should change the pouch as soon as possible when he experiences itching or burning under the skin barrier. Taping the edge of the barrier to stop leakage can backfire because it allows the effluent to remain in contact with the peristomal skin for a longer duration. Teach the patient to look at the back of the skin barrier to determine if it requires changing. A broken-down skin barrier generally has changed color. If there is a change in color, the patient will have to replace the skin barrier. Measuring the stoma The patient will have to measure the stoma every week for six weeks after surgery. That’s because of the bowel swelling resulting from surgery. During the six-week duration, the swelling decreases. After this duration, the patient will have to measure the stoma every month.
The measurement of the stoma involves the evaluation of its shape and size. Some stomas are round. They are the easiest to measure. Measuring an oval stoma can be a fraction tricky due to the difference in the width and length of the stoma, but that too isn’t quite difficult. You can use a stoma measuring guide or stoma sizer to make the process easy.
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Darron Guffey
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