Nursing Care Plan for Colostomy

Colostomy is an operation to form an artificial relationship between the colon with the surface of the skin in the abdominal wall. This relationship can be temporary or permanent forever. (Science of Surgery, Thiodorer Schrock, MD, 1983).

Colostomy may be cecostomy, transverse colostomy, sigmoid colostomy, while ascending and descending colon very rarely used to create a colostomy.

Colostomy in infants and children is almost always an emergency action, while in adults is a pathological condition. Colostomy in infants and children is usually temporary.

Indications permanent colostomy
In malignant bowel disease such as carcinoma of the intestine . Certain infectious conditions in the colon .



Which need to be assessed in patients with colostomy :

Stoma circumstances :

• Stoma color (normal reddish color).
• Signs of bleeding (bleeding wound surgery).
• Signs of inflammation (tumor, rubor, color, dolor, functio laesa).
• Stoma position.

Is there changes in fecal elimination :

• Consistency, smell, color stool ?
• Constipation / diarrhea ?
• Feces accommodated well ?
• The patient can take care of their own feces ?

Is there pain disorders :

• Complaints of pain there or not ?
• The things that cause pain ?
• Quality of pain ?
• When does pain occur ( continuous / repetitive ) ?
• Is the patient restless or not ?

Is rest and sleep needs are met ?

• Sleep well / not ?
• Stoma disrupt sleep / no ?
• Environmental factors that make it difficult to sleep ?
• Psychological factors make it difficult to sleep ?

How does the concept of the patient ?

• How patient perception to : self- identity , self-esteem , ideal self , self-image and role ?

Is there any nutritional deficiencies ?

• How the patient's appetite ?
• Normal weight or not ?
• How the patient's eating habits ?
• Foods that cause diarrhea ?
• Foods that cause constipation ?

How openness the patient ?

• Will the patient revealed the problem ?
• Can the patient to adapt with the environment ?

Assess the needs of the patient's sexual needs ?

• Ask the patient's problem sexual needs.
• Wife / husband to understand the state of the client.

Priority treatment addressed to :

• Assessment of psychological adjustment.
• Prevention of complications.
• Provision of support for self- care.
• Providing information.

Criteria for success :

• A sense of the actual adjustment.
• Complications can be prevented.
• Clients meet their own needs.
• There is support for the implementation of the treatment, knowing the potential for complications.