1-44. GENERAL NURSING IMPLICATIONS
a. It is the responsibility of the nursing staff to help the patient become
independent and self-sufficient in the care of his colostomy. However, do not permit
colostomy care and teaching to dominate the nursing interaction. Take an interest in
the patient and treat him, as a person-who just happens to have a colostomy. This will
discourage the patient from dwelling on the idea that he is somehow "different" or
"abnormal" because of his colostomy.
b. To promote self-sufficiency and return to normal living, follow these nursing
When the patient is ready, encourage participation in colostomy care.
(2) To promote a relaxed atmosphere, ensure complete privacy for the
patient if desired.
(3) To emphasize return to normal bowel evacuation habits, perform
colostomy irrigations in the bathroom while the patient is seated on the toilet.
(4) Unless contraindicated, eliminate the use of gloves during irrigation and
dressing changes. This will discourage the patient from feeling that colostomy care is a
(5) Encourage the patient to learn and perform good care. This will promote
a clean, odor-free stoma and prevent excoriation of the peristomal skin.
Follow and assist the patient as he progresses to a normal diet.
(a) Diet will aid in establishing regularity.
(b) The patient should experiment with different foods and food
combinations, as each individual responds differently to various foods. (There are no
set rules about foods to avoid.)
(c) By experience, the patient will discover which foods cause gas,
loose stools, distention, or discomfort. (Chewing slowly with the mouth closed may help
to reduce gas.)
1-45. COLOSTOMY IRRIGATION
a. Irrigation should be done at the same time each day in order to establish
regularity of bowel evacuation. Unless contraindicated or otherwise ordered by the
physician, it is best to establish a routine of daily irrigation in accordance with the
patient's former bowel habits. For example, if the patient has always moved his bowels