A practical nurse is preparing to change a one-piece ostomy pouching system for a client with an established descending colostomy. In what order should the nurse perform the following actions? Arrange the steps in the correct sequence from first to last.
- 1Don clean gloves and carefully remove the used pouch and skin barrier by gently pushing the skin away from the adhesive.
- 2Cleanse the stoma and peristomal skin with warm tap water and pat the area completely dry.
- 3Use a stoma measuring guide to determine the exact size of the stoma.
- 4Trace and cut the opening on the new skin barrier wafer approximately 1/8 inch larger than the stoma measurement.
- 5Remove the backing from the wafer, center it over the stoma, and apply firm, gentle pressure.
Cevap
The correct sequence for changing an ostomy pouch is: 1) Remove the used pouch and skin barrier, 2) Cleanse the stoma and peristomal skin with warm water and pat dry, 3) Measure the stoma, 4) Cut the opening on the new skin barrier 1/8 inch larger than the stoma, and 5) Apply the new skin barrier and pouch.
The correct sequence ensures patient comfort, skin protection, and appliance adherence. First, the old pouch must be gently removed to avoid skin trauma. Next, the area is cleansed with warm water (avoiding soaps that leave residue) and dried completely to prepare the skin. Once clean, the stoma is measured accurately, as sizes can fluctuate. The new wafer is then cut 1/8 inch larger than the measurement to prevent stomal constriction while protecting the peristomal skin. Finally, the new appliance is applied and sealed with gentle pressure.
Adım Adım Çözüm
Anahtar Kavram
Proper ostomy care requires a sequential approach focused on protecting peristomal skin integrity and ensuring a secure appliance seal.