(b) The water is too cold.
The flow is too fast.
(d) The tube contains air.
m. Clamp the catheter and remove from the stoma. Fold down the top opening
of the irrigation drain pouch and secure it in the closed position.
n. Have the colostomy patient sit on or near the toilet for about 15 to 20 minutes
so the initial colostomy returns can drain into the toilet. (If the patient is on bed rest,
allow the colostomy to drain into the bedpan.)
o. Close the colostomy irrigation drain pouch with a rubber band or pouch clip,
then ambulate the patient, or return him/her to bed.
Ambulating stimulates elimination, producing improved irrigation return.
(2) Have the non-ambulatory patient lean forward or massage his/her
abdomen to stimulate return.
p. Wait approximately 1 hour for the rest of the colostomy return, then remove
the irrigation drain pouch from the patient.
q. Gently clean the area around the stoma with mild soap and water.
Be careful not to rub the skin.
Rinse and dry the area with a towel.
r. Apply a clean pouch or dressing, as applicable.
s. Provide for the patient's comfort; remove and dispose of used supplies.
t. Record the procedure and significant nursing observations in the patient's
clinical record and report it to charge nurse.
Note color and condition of stoma and peristomal skin.
Record color, consistency, and amount of drainage.
Note amount of irrigating solution used.
u. As recovery progresses, the nursing personnel should gradually assume a
more passive role in colostomy care, allowing the patient to assume the active role.