The home health nurse is teaching a client how to independently change a one-piece colostomy pouch. In which order should the client perform the following steps to ensure proper skin protection and pouch adhesion? (Arrange the steps from first to last.)
- 1Gently remove the old pouch and skin barrier.
- 2Clean the stoma and surrounding skin with warm water.
- 3Pat the peristomal skin completely dry.
- 4Measure the stoma and cut the new skin barrier to fit.
- 5Apply the new skin barrier and pouch over the stoma.
Answer
The correct sequence is: remove the old pouch, clean the stoma and surrounding skin, pat the skin completely dry, measure and cut the new barrier, and finally apply the new barrier and pouch.
A systematic approach to colostomy care ensures peristomal skin integrity and a secure pouch seal, promoting client independence. The client must first gently remove the old appliance. Next, they clean the stoma and peristomal skin with warm water. It is critical to pat the skin completely dry afterward because moisture prevents proper barrier adhesion. Once the skin is clean and dry, the client measures the stoma and cuts the new barrier to the correct size to protect the skin from effluent. Finally, the new pouch is applied and secured.
Step-by-Step Solution
Key Concept
Ostomy Self-Care and Pouching Sequence