Urinary stoma care
Set of activities performed by the nurse to a patient with a urinary stoma.
Objectives:
– Maintain patency of the urinary stoma. – Maintain the urinary stoma in hygienic conditions. – Maintain the integrity of the peristomal skin. – Educate the patient and family on urinary stoma maintenance care.
Equipment:
– Basin. – Scissors. – Scissors. – Towels.
Material:
– Non-sterile disposable gloves. – Urinary stoma equipment. – Waste bag. – Soaker. – Neutral soap. – Sponges. – Compresses or gauze.
Procedure:
– Wash hands. – Prepare material. – Preserve the patient’s privacy. – Explain the procedure to the patient. – Ask the patient and family to cooperate. – Put on non-sterile gloves. – Place the patient in the supine position with the soaker under the patient. – Gently remove the used bag from top to bottom, holding the skin with the other hand. – Clean the stoma and peristomal skin from the inside out with circular movements, using warm water and neutral soap. – Dry the stoma and surrounding skin thoroughly. – Observe the appearance of the stoma and the surrounding area. – Measure stoma diameter and trim the disc. – Select pouch appropriate to the characteristics of the ostomy. – Remove protective paper and apply disc on stoma with massage both inside and outside the ring, to get a good fixation of the dressing.
– Apply the collecting bag to the disc by means of the connection rings. From bottom to top. – If 2nd degree dermatitis appears, apply hydrocolloid or hydrogel type protective dressing, adjusting it to the diameter of the stoma and place the two-piece device on top. – Collect the material. – Leave the patient in a comfortable position. – Remove gloves. – Wash hands. – Record in the nursing documentation the procedure performed, reason, date and time, incidences and patient response.
Remarks:
– Devices should be changed when the bag reaches two thirds of its capacity. In cases of open devices: empty the bag when it reaches two thirds of its capacity and change it every 24 hours. – If there is obstruction of the urinary stoma by bleeding due to the surgical intervention, aspirate and wash. – If there is infection of the surgical wound, inform the physician and treat with saline and antiseptic solution every 24 hours. – Urostomy bags are usually open to empty the urine without having to change the bag. – If there is no contraindication, increase fluid intake, urine should be as little concentrated as possible. – Avoid excessive weight gain of the patient. – The patient should wear comfortable clothes avoiding compressing the bag. – Make the patient and family aware that the stoma is not an obstacle for bathing or showering. – For initial patient education on stoma care, avoid the hours after meals because bowel activity increases.
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