skin
Procedures
SN Instructed to the urostomy care: How to change the Urostomy bag: Prepare the new bag. Gather everything you need in the bathroom: plastic bags, toilet paper, paper towels or a soft washcloth, a clean cloth wipe, an additional skin barrier in the form of a paper towel (if desired) and a new bag.If the bag you use does not come with a skin barrier already made, take the measurements and now form the opening with scissors. Slowly remove the skin barrier lining. Put aside the skin barrier. Empty the used bag before removing it. To empty the bag, sit on the toilet or stand in front of it: Remove the used bag. To remove the used bag, sit on the toilet or stand in front of it. Carefully separate the skin from the skin barrier with one hand. To do this, start at the top edge of the skin barrier. With the other hand, slowly release the skin barrier from top to bottom. Seal the used bag tightly inside a plastic bag and dispose of it in the trash: Clean the area around the stoma. Use toilet paper to clean urine and mucus in the stoma or the skin around it. Clean the skin with warm water and a soft cloth wipe or a paper towel. Clean up to the stoma border. You can also do this while showering. Dry the skin without rubbing, using a clean towel; and Place the new bag. Use a folded paper towel or a piece of gauze to keep the stoma dry while placing the new pouch. Once you have changed the bag, wash your hands.
Instructed patient to check your skin and the back of your skin barrier each time you change your pouching system. You can use a mirror to check your skin under the stoma. Look for any places where stool or urine may have leaked under the skin barrier and onto your skin. When you apply your next pouching system these areas may need some extra reinforcement with skin barrier strips, rings or paste.
Instructed patient when you have a stoma that drains urine or loose stool you may want to consider using an extended wear skin barrier because it will give your skin added protection. Itching or burning under the skin barrier may indicate that you have leakage, a skin rash, or a skin infection. You need to remove your pouching system as soon as possible to check your skin for any irritation.
Empty your pouch when one-third to one-half full. Change your skin barrier every 3-7 days. You should not experience frequent leakage of your pouch seal. If you do, consult a WOC Nurse. Usually soap is not needed to clean the peristomal skin. If you use soap, make sure it does not contain any oils or lotions that can interfere with adhesives. Always rinse your skin and dry completely before you adhere the new pouch. After you apply your skin barrier, hold it in place against your skin for about one minute. This will help to activate the adhesive. You can shower, bathe, or swim with your ostomy after you are cleared by your physician. If you are using a bedside collection bag, clean it daily with a recommended solution to help minimize odor, crystal formation, and bacteria.
Instructed patient call your doctor if it is does not get better when you treat it.If your stoma is leaking, your skin will get sore, be sure to treat any skin redness or skin changes right away, when the problem is still small. Do not allow the sore area to become larger or more irritated before asking your doctor about it, If your stoma becomes longer than usual (sticks out from the skin more), try a cold compress, like ice wrapped in a towel, to make it go in.
Instructed patient To care for your skin:Wash your skin with warm water and dry it well before you attach the pouch.
Avoid skin care products that contain alcohol. These can make your skin too dry.
Skilled nurse assess patient for S/S of complication related to diagnostic.
Instructed caregiver about your Foley catheter daily Care: Keep the skin and catheter
clean. Clean the skin around your catheter at least once each day. Clean the skin area and
catheter after every bowel movement. Call the patient MD if: you cannot get the catheter to
drain urine into the bag, the catheter comes out or it is leaking, the urine is thick and
cloudy. Your urine has mucus, red specks, or blood in it. Urine with blood in it may appear
pink or red. the urine has a strong (bad) smell, No urine has drained from the catheter in 6 to
8 hours, have pain or burning in your urethra, bladder, abdomen, or lower back, have shaking
chills or your temperature is over 101° F (38.3° C).
Instructed patient If you do put tape around the skin barrier edges do not remove the tape after water activities. Removing the
tape may cause the skin barrier to loosen. It is helpful to hold your skin smooth as you put your pouching system on to avoid wrinkles that may lead to leakage.
Instructed patient the stoma is your bowel. It is protected by mucus so stool or urine won’t hurt it. A stoma rarely becomes infected. The most important thing is to protect the skin around your stoma. A correct fitting pouching system is the best way to prevent an infection of your skin. If there is a small leak under my skin barrier, is it okay to patch it with tape or paste: Always change your pouching system at the first signs of leakage.
Instructed patient If there is a small leak under my skin barrier, is it okay to patch it with tape or paste: Do not try to patch the pouching system with tape or paste. A leak under the skin barrier should not be fixed. Leaving a leaking pouch on can cause skin irritation. Always empty your pouch before it is half-full. Release gas before the pouch gets too full. If you have a lot of gas, you may want to consider using a pouch with a vent or filter.