Nursing care plan for colostomy

Introduction

A colostomy is the surgical technique of rerouting one end of the large intestine, or the colon, through an incision in the abdomen wall. A colostomy may be temporary or permanent. It is done when there is damage to a portion of the colon that needs treatment because of fecal incontinence, cancer, diverted colons, Crohn’s disease, and etc. A patient with colostomy needs a care plan that is specifically designed for his/her medical condition. The plan should include assessments, nursing diagnosis, outcomes, interventions, rationales, and evaluations.

Assessment

• Health History - The nurse should review the patient’s health history and recent hospitalizations, medications taken, allergies, cultural beliefs, family roles and relationships, diet, activity level and economic resources.
• Colostomy Status - The patient’s current colostomy status should be determined, including size, location, type, and stomal output.
• Skin Integrity - The nurse should monitor the skin around the stoma, the surrounding area and the peristomal skin for color, texture, temperature and odor.
• Psychosocial Status - The nurse should assess the patient’s emotional status and coping skills.
• Nutritional Status - The nurse should evaluate the patient’s weight and dietary intake.

Nursing Diagnosis

• Ineffective Skin Integrity related to mechanical irritation from stoma.- Due to the presence of the stoma, the skin surrounding the stoma is prone to premature breakdown.
• Impaired Socialization related to negative body image.- Patients may feel frustrated, depressed, and unmotivated because of their impaired socialization.
• Impaired Nutrition, Less Than Body Requirements related to inadequate gastric absorption.- The stoma can decrease the absorptive ability of the gastrointestinal tract, leading to inadequate gastric absorption.

Outcomes

• Patient will demonstrate intact skin around the stoma and peristomal skin.
• Patient will maintain a positive body image.
• Patient will meet nutritional requirements.

Interventions

• Perform regular ostomy checks and monitor stomal output.
• Instruct patient in proper skin care surrounding the stoma and peristomal skin
• Assess patient's psychosocial and nutritional needs.
• Provide guidance and support to patient and family members.
• Encourage patient to discuss feelings about ostomy and fears about body image
• Encourage patient to participate in physical activity and maintain healthy lifestyle

Rationales

• Regular ostomy checks allow the nurse to assess the stoma and skin changes.
• Proper skin care prevents possible skin irritation and breakdown.
• Patient's psychosocial and nutritional needs will be assessed in order to address any potential problems.
• Guidance and support will help improve patient's quality of life.
• Discussing feelings and fears can help patients process difficult emotions.
• Physical activity and healthy lifestyle are important for the overall well being of the patient.

Evaluation

• Monitor stomal output, skin integrity, and nutritional intake regularly.
• Assess patient's psychosocial and emotional status.
• Assess patient's compliance to prescribed skin care routine and lifestyle modifications.

Conclusion

The development of an individualized nursing care plan for a patient with colostomy is essential to ensure the individual receives the best possible care. The plan should include assessments, nursing diagnoses, outcomes, interventions, rationales, and evaluations. It is important for nurses to understand the complexities of colostomy care in order to provide comprehensive and patient-centered care.

Frequently Asked Questions

1. What is the purpose of a nursing care plan?
   The purpose of a nursing care plan is to provide an individualized plan of care to meet a patient’s specific needs.
2. What are the components of a nursing care plan?
   The components of a nursing care plan include assessments, nursing diagnosis, outcomes, interventions, and evaluation.
3. What are some common nursing interventions for patients with colostomies?
   Common nursing interventions for patients with colostomies include performing regular ostomy checks, educating the patient about proper skin care, assessing psychosocial and nutritional needs, providing guidance and support, and encouraging physical activity.
4. How can nurses monitor the patient’s progress?
   Nurses can monitor the patient’s progress by monitoring stomal output, skin integrity, and nutritional intake; assessing psychosocial and emotional status, and assessing patient’s compliance to prescribed skin care routine and lifestyle modifications.
5. What should nurses do to ensure the best possible care for a patient with colostomy?
   Nurses should develop an individualized nursing care plan based on the patient's specific needs, understand the complexities of colostomy care, and provide comprehensive and patient-centered care.