Care For Patient Undergoing A Ileostomy Nursing Essay

Cargon For Patient Undergoing A Ileostomy Nursing assayThe forbearing involved was supposed to make c ar of an ileostomy. In this scenario, the unhurried must eat a well balanced diet regularly and also drink at least six glasses of wet. The patient should also try nigh six small meals per daylight instead of three heavy(p) meals. The patient should also insist on alimentation solid food before taking in both fluid to avoid gurgling in the porech. Food such as garlic, onions, cabbage, broccoli or asparagus may recrudesce flavor. Even if the pouch is olfactory sensation proof, consume this type of food may create a strong odor while emptying the pouch. It is therefore advisable for the patient to avoid these kinds of foods. Meals with parsley, buttermilk and yoghourt gouge reduce the odor.ThoughtI intended to reduce the odor that comes as result of the food that the patient may be devour ignorantly. The odor generates a lot of comfort to the patient and even those who are a bicycle him and this mint easily lead to stigmatization of the akin patients who cherished a close monitoring to ensure quick recovery.Feelings.The feeling at the time was that of sympathy beca economic consumption well-nigh of the patients with this motive are highly stigmatized non because of their wish but because of their ignorance. The reason why i designed this inscription was to ensure that such kind of government agencys is minimized.EvaluationEverything went as planned with a few mistakes due to forgetful exposure to these figure of speech of treatment to the patient. close patients start out non been exposed to this kind of medical economic aid and therefore very few of them know either nonhing or little about the condition. Fear is a major concern to the patient with nigh of them still sticking to their traditions and thinking that certain practices are considered taboos in their purificationAnalysisThe reason why there was some success is beca use of the co unconscious process by the target patient and also some education on the bene perishs that are going to be realized if the patient sticks to the highlighted rules e.g. avoiding certain types of food to disclose the smell. This was mainly influenced positively by the use of examples and close monitoring of the same patient. Examples highly motivated the patients and giving them chances to test on the issue.ReframeThe alternative to this situation is the use of force especially if the patient refuses to follow or amaze to instructions as it was in m both cases. Use of force evoke make most patients to stick to the rules and adapt to them with time.Future actionFrom this case, it is advisable that before any kind of t all(prenominal)ing is perform, it is imperative that the patient be thoroughly exposed to some of the practices the are going to help him or her to an easy time during the teaching. The mode of teaching should not entail much detail but just an over take hold of of the practices that are intended to be adhered to on a regular basis by the patient.Reflective account different GI and genitourinary etiologies may need the creation of urinary or fecal diversion. These may implicate inflammatory bowel malady, diverticular disease, intestinal obstruction, colon-rectal cancer, gynaecological cancers and gastrointestinal trauma (Beitz, 2004). Indications for coming up with the urinary porete include neurogenic bladder, bladder cancer, refractory radiation cystitis and interstitial cystitis. The cause of the disease depart determine if the condition will be a fugacious or permanent matchless (Thomas McGinnis, 2004).Among various types of operatively created ostomies, colostomy involves the rise do on the large intestine to supply for the passage of dope. The location of colostomy can be in sigmoid, transverse or ascending position. In this case, running(a) resection will ultimately determine the tail end product dead body. Ileostomy is a surgical construction from the small intestine and it is primed(p) high in the gastrointestinal route hence the stool output is comparatively of high criterion and liquid consistency (Gordon and Vasilevsky, 2004). Ileal conduit or urostomy is made using a little(a) portion of the ileum to sanction in urine elimination. Ureters are connected to conduit to allow urine to flow out of the body into ostomy pouch through the pore (McGinnis Tomaselli, 2004). Whether the ostomy is temporary or permanent, nurses must posses the knowledge to give the patient and the family the necessity information to improve recovery and enable a positive produce when obtaining information about ostomy direction.Patient groomingAny patient who is plan for an ostomy surgery can experience a number of feelings like fear, anxiety, depressive disorder and loss of body image especially if the cause of the surgery is a diagnosis related to cancer. Pre operative teachings assist the patien t by receiving these feelings and supply to quick recovery of the patient (Oshea, 2001). A very important subdi plenty in the teaching procedure before the operation is the Wound Ostomy and self-importance-control Nurse (WOCN). Counseling before the operation allows for the assessment of the patients knowledge about the disease, support systems, level of education, employment, physical activity involvement, financial concerns and hobbies. Assessment of any physical shortcomings is also necessary because poor manual dexterity, poor vision and loss of hearing may affect the patients ability to undertake ostomy self care. Patients spiritual and cultural beliefs should be also assessed because certain particular rituals concerning ostomy care may need to be taken in. Employing all these factors can assist the patient to recover successfully and feel confident in managing the condition (Oshea, 2001).WOCN reviews the cause of the disease, stoma characteristics, surgical procedure, peris tomal pelt care, dietary considerations and a mixing of ostomy appliances. If appropriate teaching proceedings may enable the patient to have an insight of the ostomy pouching system. Use of teaching booklets and illustrations helps to improve the education.Another component of operative teaching is the stoma situation marking. This is recommended for all who are set to brook a permanent or temporary stoma (Goldberg and Carmel, 2004). A peaked(predicate) located stoma on the patients abdomen can lead to peristomal spit out complications, stool and urine leakage, stoma, emotional and physical stress for the patient. During stoma position marking, there is abdomen assessment with the patient in sitting stand and lying positions. Also the abdomen can be assessed for the pare down folds, bony, creases, scars and prominences. Patients blast and line should be avoided from the stoma site and not affect any prosthetic devices. The stoma site should also be put in an area that the patient can visualize and access. Ideal stoma site is situated in the anal muscle that extends to symphysis from the xyphoid process (Goldberg and Carmel, 2004).Nursing EducationIn stoma assessment the patient must enter the operational room with the pouching system on stoma. Immediately after the operation the, a transparent pouch is recommended to enable the nurse to have a view of stoma characteristics and stool and urine presence (Goldberg and Carmel, 2004). Initially after the operation period, the stoma can appear edematous, red, shiny and moist. In general terms, the stoma is red to pink in color according to tissue that was apply in construction. Brown to dark color may show stoma ischemia and the consultations must be made with the physician.The shape of the stoma ranges from eke out to oval. It changes its shape and size of it in a period of six to 8 weeks after the surgery. Since the stoma decreases in size with time, the nurse must use a skin prohibition that has been cut to fit to the stoma (Goldberg and Carmel, 2004). For the initial six to eight weeks after the surgery, measurements of the stoma should be taken each time the barrier of the skin is changed. Measuring guides are provided to measure round stomas, oval stomas will need the length and width measurements of the stoma (Colwell, 2004). need of sphincter by the stoma to regulate the passage of urine or stool, then the opening should be placed near the center of the stoma to aid the flow of urine and stool (McCann, 2002).The stoma may not or may protrude out of the skin surface. Stomal forcing out varies from a slopped stoma at the skin level to a normalize one which is about 1-3 cm in length (Erwin-Toth and Doughty, 2002). Actually, stoma protrusion should be at least 0.8 inches above the skin level (Colwell, 2004). stick out stoma helps urine and stool to flow into the pouch directly. A flush stoma is not suitable because it can cause difficulties when skin barrier attaches to it and leakage of stool below the skin barrier leading to peristomal skin irritations.The stoma output is determined by the location of ileostomy. The output resulting form the ascending colon produces a semi liquid consistency whereas the one from the transverse colon produces a semi-liquid to pasty consistency and the one located in a sigmoid or descending colon will be more of a solid stool (McCann, 2002).An Ileostomy stool output is constant and watery with a lot of digestive salt and digestive enzymes. At the initial postoperative stages, the stool may be gullible and thick. The stool output from Ileostomy range from 800-1,700 cc in one day (Colwell 2004). When the patient comes back to the regular diet, there is development of the stool consistency from the ileum and a reduced out put in a insouciant basis ranging from 500-800cc/day. With time the small intestines recovers and with a decrease in stool output (McCann, 2002). Urine is immediately produced after the surgery by the Ileal conduit stomas. It is unremarkably normal for the urine to be blood-tinged after the operation. Also the small intestines produce mucous which may be seen in urine (Colwell, 2003).Peristomal skin care involves the protection of the peristomal from coming into contact with the urine and stool to stop the incident of peristomal skin complications. scrape up barrier needs to be properly metrical to suit the stoma. If the skin barrier opening is too large, urine or stool will cause irritation on the peristomal skin area. The opening should not be more than 2cm larger than the size of the stoma. Cleanliness of the peristomal skin can be done by gently using warm water then dry it. Moisturizing soaps must be avoided because they affect negatively the skin barrier attachment. Male patients need to be taught trimmed peristomal using electric car razor, scissors and other safety devices in an outward manner from the stoma (McCann, 2002).When choosing the pouching system of the patient, the information that was gathered before the operation is heavily relied upon. different factors to be considered include location of the stoma, its size and shape plus the anatomical location. Pouching system should give anticipated wear time and protect the central skin from stool and urine (Colwell, 2003). Most of the pouching systems are designed in a way that the weight is light, easy to maintain and odor-proof (Colwell, Carmel and Goldberg, 2001).One of the most important components of the pouching systems is the skin barrier because it protects the peristomal skin from stool and urine (Colwell, 2004). Skin barriers can be found in either cut-to fit or pre-cut product. The pre-cut models are meant for the round stomas. Barrier opening should fit stoma size to limit the probability of the urine and stool coming into contact with the peristomal skin. The cut-to fit models can be used in oval stomas or the ones which are irregular in shape. The cut-to fit barriers are the commonly recommended in initial postoperative stage because the size of the stoma will reduce for not less than six to eight weeks from the day the surgery was performed. A large skin barrier may cause peristomal skin problems resulting from the exposure to stool or urine (Colwell, 2004).