A nurse in a gastrointestinal outpatient clinic is instructing a client with a new colostomy on how to independently change their one-piece ostomy pouching system at home. In what order should the client be taught to perform these actions? Arrange the steps in the correct sequence.
- 1Remove the used pouch and skin barrier by gently pushing the skin away from the adhesive.
- 2Cleanse the stoma and surrounding skin with warm water and dry it completely.
- 3Measure the stoma using the measuring guide template.
- 4Cut the opening on the new adhesive skin barrier to be slightly larger than the stoma.
- 5Remove the protective backing and apply the new skin barrier firmly around the stoma.
Answer
The correct sequence is: remove the used pouch, cleanse and dry the stoma and skin, measure the stoma, cut the opening on the new barrier, and apply the new skin barrier.
When changing an ostomy pouch, the client must first carefully remove the old appliance. The peristomal area is then cleaned with warm water and dried completely to ensure a healthy, residue-free skin surface. Next, the stoma is measured, as its size decreases over time. The client then cuts the skin barrier to fit the measurement, leaving a small gap (about 1/8 inch) to avoid strangulating the stoma. Finally, the protective backing is removed, and the appliance is pressed firmly onto the skin to create a secure, leak-free seal.
Step-by-Step Solution
Key Concept
Ostomy Self-Care and Appliance Management