Ostomy Care

Patient Needs

Support residents with a surgically created stoma that diverts stool or urine into a collection pouch.
Common Types:

• Colostomy: Stool exits through a portion of the large intestine.
• Ileostomy: Stool exits through a portion of the small intestine.
• Urostomy: Urine drains through a surgically created urinary diversion.
  Goals:
• Maintain hygiene and comfort.
• Protect the stoma and surrounding skin.
• Prevent leakage and infection.
• Preserve dignity and independence.

What Should I Assess?

Stoma:

• Normally pink to red and moist, with some variation in color.
• Observe changes in color, size, swelling, or appearance.
  Peristomal Skin (Skin Around Stoma):
• Redness, irritation, rash, or open areas.
• Moisture damage from leakage.
• Pain, itching, or burning.
  Output:
• Amount, consistency, color, and unusual changes.
• Unexpected decrease or absence of output.
• Leakage or difficulty maintaining the pouch seal.

How Do I Provide Care?

Emptying the Pouch:

1. Explain care and provide privacy.
2. Perform hand hygiene and wear appropriate PPE.
3. Empty the drainable pouch when approximately 1/3 to 1/2 full, or as directed.
4. Drain into an approved container, avoiding splashing.
5. Clean the pouch outlet and secure the closure.
6. Measure and document output when required.
7. Clean equipment and perform hand hygiene.
   Stoma & Skin Care:

• Observe the stoma and surrounding skin during routine care.
• Keep exposed skin clean and dry using approved methods.
• Protect skin from contact with urine or stool.
• Report leakage or damaged skin promptly.
• Assist with pouch changes only when authorized, trained, and directed.
  Promoting Independence:
• Encourage residents to participate in pouch care when able.
• Respect privacy, body image, and personal preferences.
• Provide emotional reassurance and practical assistance.

Safety & Precautions

• Do not pull, rub, or apply pressure directly to the stoma.
• Never insert anything into a stoma without specific authorization and training.
• Use only approved skin products; oils and lotions may interfere with pouch adhesion.
• Follow the care plan for pouch emptying and replacement.
• Do not simply tape over a leaking skin barrier; notify the nurse for appropriate replacement.
• Avoid applying unfamiliar products to irritated peristomal skin.
• Stoma appearance and output expectations vary by ostomy type.

What Should I Report?

Report promptly:

• New redness, rash, blisters, or open skin.
• Persistent leakage or a poorly fitting pouch.
• Unusual pain, swelling, or bleeding.
• Unexpected changes in urine or stool output.
• New abdominal pain, distention, nausea, or vomiting.
  Urgent concerns:
• Stoma becoming dusky, dark purple, gray, or black.
• Sudden cessation of output with concerning symptoms.
• Significant bleeding or severe abdominal pain.

Related

• Ostomies & Diversions
• Elimination Care
• Incontinence Care
• Skin Integrity & Breakdown Prevention
• Standard Precautions

Sources

• CNA Module 8 — Ostomies
• WOCN — Basic Ostomy Skin Care
• WOCN — Peristomal Skin Assessment Guide

Flashcards

What stoma changes should be reported?03-application / patient-care

Answer

Unusual color, bleeding, pain, leakage, or changes in output.