Lesson 45. Colostomy Irrigation
1-45. COLOSTOMY IRRIGATION
a. Irrigation should be done at the same time each day in order to establish regularity of bowel evacuation. Unless contraindicated or otherwise ordered by the physician, it is best to establish a routine of daily irrigation in accordance with the patient's former bowel habits. For example, if the patient has always moved his bowels after breakfast, establish the irrigation routine for that time, rather than some other arbitrary schedule.
b. Review the procedure with the patient, if necessary.
c. Wash your hands.
e. Provide for privacy.
f. If the patient is ambulatory, have the patient sit on the toilet or on a chair facing the toilet. If the patient is bedridden, elevate the HOBº 45-90ºand position Chux around the patient.
g. Fill the irrigation bag with the prescribed solution and hang it on the IV pole or hook.
h. Open the clamp on the irrigation tubing and allow the solution to fill the tubing. Reclamp. (This prevents the administration of air into the intestines.)
i. As necessary, prepare to begin the colostomy irrigation (see figure 1-6).
Figure 1-6. Colostomy irrigation.
j. Lubricate the cone with the water-soluble lubricant to avoid irritating the mucous membranes.
k. Gently insert the cone into the stoma so that the stoma is occluded.
l. Unclamp the irrigating tubing and allow the water to flow in slowly.
m. Clamp the catheter and remove from the stoma. Fold down the top opening of the irrigation drain pouch and secure it in the closed position.
n. Have the colostomy patient sit on or near the toilet for about 15 to 20 minutes so the initial colostomy returns can drain into the toilet. (If the patient is on bed rest, allow the colostomy to drain into the bedpan.)
o. Close the colostomy irrigation drain pouch with a rubber band or pouch clip, then ambulate the patient, or return him/her to bed.
p. Wait approximately 1 hour for the rest of the colostomy return, then remove the irrigation drain pouch from the patient.
q. Gently clean the area around the stoma with mild soap and water.
r. Apply a clean pouch or dressing, as applicable.
s. Provide for the patient's comfort; remove and dispose of used supplies.
t. Record the procedure and significant nursing observations in the patient's clinical record and report it to charge nurse.
u. As recovery progresses, the nursing personnel should gradually assume a more passive role in colostomy care, allowing the patient to assume the active role.
David L. Heiserman, Editor
Publisher: SweetHaven Publishing Services
Copyright © 2006, SweetHaven Publishing Services