A nursing care plan for a patient living with a colostomy .

 

A nursing care plan for a patient living with a colostomy:

A colostomy is a surgical procedure in which an opening, called a stoma, is created in the abdominal wall to divert the colon (large intestine) to an external pouch. This procedure is typically performed when a portion of the colon or rectum is diseased, damaged, or removed due to conditions such as colorectal cancer, inflammatory bowel disease, diverticulitis, or traumatic injury. The stoma allows waste material to exit the body directly into a colostomy bag, bypassing the normal route through the rectum and anus.

The colostomy can be temporary or permanent, depending on the underlying condition and the patient's prognosis. In some cases, after the colon heals or recovers, the colostomy can be reversed, and normal bowel function can be restored. However, in other cases, particularly when the rectum is completely removed, the colostomy may be permanent.

Living with a colostomy requires significant lifestyle adjustments, including learning how to care for the stoma, managing the colostomy bag, and addressing any emotional and psychological challenges. Proper education and support from healthcare providers are crucial for helping patients adapt to life with a colostomy and maintaining their quality of life.

A nursing care plan for a patient living with a colostomy .:

Nursing Diagnosis	Goals/Expected Outcomes	Nursing Interventions	Rationale	Evaluation
Risk for impaired skin integrity related to stoma output and adhesive appliances.	The patient will maintain intact skin around the stoma with no signs of irritation or breakdown.	1. Assess the skin around the stoma for redness, irritation, or breakdown every shift.	Early detection of skin problems can prevent further complications.	The patient’s peristomal skin remains intact with no signs of irritation.
		2. Clean the peristomal skin gently with warm water and pat dry; avoid using harsh soaps or alcohol-based products.	Gentle cleansing prevents skin irritation and maintains skin integrity.
		3. Apply a skin barrier product as recommended to protect the skin from stoma output.	A skin barrier can protect the skin from the irritating effects of stoma output.
Body image disturbance related to the presence of a colostomy as evidenced by verbalized concerns about appearance.	The patient will verbalize acceptance of the colostomy and participate in self-care activities.	1. Encourage the patient to express feelings about the colostomy and body image changes.	Verbalizing feelings can help the patient process emotions and reduce anxiety.	The patient expresses feelings and concerns and shows signs of adjustment.
		2. Provide education on how to manage the colostomy and encourage independence in colostomy care.	Education empowers the patient and promotes self-confidence in managing the colostomy.
		3. Refer the patient to a support group for individuals with colostomies.	Support groups offer emotional support and shared experiences that can help with adjustment.
Risk for infection related to stoma care and handling of the ostomy pouch.	The patient will remain free from infection as evidenced by normal temperature and absence of redness or discharge around the stoma.	1. Teach the patient and caregivers proper hand hygiene before and after handling the stoma and ostomy supplies.	Proper hand hygiene is essential to prevent infection.	The patient and caregivers demonstrate proper hand hygiene and no signs of infection are present.
		2. Change the ostomy pouching system as needed, ensuring a proper fit to prevent leakage.	A properly fitting pouching system minimizes the risk of infection by preventing leakage of stool onto the skin.
		3. Monitor the stoma and surrounding skin for signs of infection, such as redness, swelling, or discharge.	Early detection of infection allows for prompt treatment.

This is a simplified version of a nursing care plan that you can expand or modify as needed. Each row represents a different aspect of care, and you can add more rows to cover additional nursing diagnoses or interventions specific to the patient's condition.