Ostomy Care: Introduction (Nursing)

00:04 Hi guys let's talk about ostomy care, now this is actually quite a bit of a bigger topic than you might expect, you could see this anywhere from pediatrics to adult patients so during this presentation we're going to talk about what is an ostomy, important nursing care that's needed for those type of patients and also really important skills to maintain it, so let's take a look. So let's pause a minute on this slide, you may say okay ostomy I haven't really heard of it why is this even important but let's take a look at this number this is pretty shocking to me. So the number of people with ostomies in the U.S. can range anywhere from 750,000 to 1 million, now that's a lot more honestly than I even expected. The other thing to consider is there around a hundred thousand new ostomy surgeries each year, again that's a pretty astonishing number if you sit and think about it. Now most of these ostomy surgeries these could be temporary and we're going to talk a little bit about that later. So we just talked about how many ostomies there can be out there, now let's take a moment and talk about okay what is an ostomy ? So if you take a look at the side with the patient, you notice that there's a great illustration of the patient's large intestine or if you remember colon, so large intestine or colon, remember that. The patient's large intestine if you remember is going to be on the left side, so again let's go back to this graphic so if you take a look at this picture you're going to see an illustration of the patient's large intestine here, you also see that little pink circle that's something we're going to talk about and focus on, so believe it or not in this picture on this patient that you're seeing that's actually a piece of the patient's large intestine brought to the surface, yeah okay that sounds a little weird I know but we're going to get into this a little bit more as well. So now let's take a look at the other illustration with just the intestine itself and the pouch. So if you're a member, the large intestine or the colon is part of your digestive tract so as part of your digestive tract of course stool or feces is going to go through that right? So if you see that little picture this pouch that you're looking at, that's going to be there to catch it. Now let's take a look at a great definition of what is an ostomy, really the ostomy itself is just a surgical opening and it's going to allow stool or urine to leave the body, now you may wonder okay how does a patient even get this? Well this can occur if a patient has maybe colon or rectal cancer for example, some sort of intestinal blockage, trauma can cause it or if a patient has like an abscess or inflammation or infection so there's quite a bit of things that can happen here. So let's pause to remember back we talked about sometimes these can even be temporary so what we mean by this is sometimes if you look at this picture let me orient you to that, you see all those little pouches or those little bubbles you see on the large intestine, sometimes those things can get inflamed or infected or there could be issues here to where surgically we have to remove part of that, so sometimes we create an ostomy to allow the bowel to rest, recover and then we can remove the ostomy and reattach or redo another surgery so the patient does not have to have that ostomy anymore. So again the ostomy sometimes is created just allow the bowel to rest surgically and then they can reverse that so the patient does not need that anymore.

03:48 So we're talking about ostomies, really it's you're going to know more about that ostomy because they're named by their location so that's really convenient for us so if you take a look here on the colostomy picture, if you remember, colon or large intestine again there's that location for your colostomy is going to be in that large intestine or the colon. Now if you look here in the middle, the ileostomy that's the last part of your small intestine called the ilium so again that's the ileostomy, so that's really helpful for us as nurses right. So let's go back and talk about that anatomy again so one thing is a nurse to expect between the colostomy and the ileostomy, think about your digestive process, now your clot your colon is farther down in that digestive process so you should see a little bit more form stool here in the colostomy if the patient has that, now higher up in the digestive process if you remember, the small intestines a little bit higher up there in that process so the stool coming out of that is probably going to be a little bit more liquid and soft, so that's a good comparison and lastly look at the urostomy picture. So again going back to that anatomy guys, you remember those ureters are attached to the kidneys, so you can take that ureter, bring it to the surface and create an urostomy, so now what's going to come out of that? Okay, urine is going to come out of that. If you recall ostomies can remove either stool, feces or urine out of the body. Okay so we just talked about ostomies, now let's talk about what is a stoma? You're probably thinking okay great, here's another word here, but let's re-look at this graphic that we looked at earlier so if you see on the patient's side you see that little pink circle, when we're talking about a stoma this is what we're going to be paying attention to. Also, if you take a look at the other graphic of the large intestinal colon, you see the pouch that's attached to the pink circle. Well that pouch is what's going to go around the stoma and catch any stool or feces here. Now really the stoma is just the opening of the abdomen and it looks like a small pinkish circular piece of flesh, sounds kind of weird right? But this is actually sewn to our body and also know any time you see a patient's stoma, it's going to vary just a little bit, it could be kind of fairly flat to the body, it could protrude out a little bit the size may differ just a little bit, so just know you may see some variations here. Now one key note before we leave, sometimes you may in nursing report hear from another nurse, the patient in 952 has a stoma or they have an ostomy. You may kind of hear these words interchangeably, so know that that just may come up for you.