Colostomy Care: Comprehensive Nursing Notes & Management

 Introduction:

While a colostomy is a life-saving procedure, nurses must monitor patients closely for potential complications to ensure early intervention and patient safety.

Common Complications:

Stoma Ischemia/Necrosis: This occurs due to inadequate blood supply. The stoma will appear dark purple, dusky, or black instead of the healthy beefy red.

Peristomal Skin Breakdown: Irritation or infection of the skin surrounding the stoma, often caused by stool leakage under the skin barrier.

Parastomal Hernia: A bulge behind or around the stoma caused by loops of intestine pushing through a weakness in the abdominal muscle.

Stoma Retraction: The stoma sinks below the skin level, making it difficult to attach the pouching system and leading to leaks.

Stoma Prolapse: The bowel protrudes through the stoma opening more than it should, often caused by increased abdominal pressure.

Stenosis: Narrowing of the stoma opening, which can lead to bowel obstruction.

Nursing Management:

Assess stoma color and moisture every 4–8 hours during the first 24 hours post-surgery.

Measure the stoma carefully to ensure the skin barrier fits perfectly to prevent leakage.

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Educate the patient on signs of infection, such as fever, increased redness, or unusual discharge.

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