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Lesson 44. General Nursing Implication
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 guidelines.
- (1) 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 "dirty" procedure.
- (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.
- (6) 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.)
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