Research and Application to Nursing Care

Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example

Colostomy irrigation involves removing stool without regular wearing of a colostomy bag, whereby the colon is washed with water using a stoma (Cuzner, 2019). The procedure is conducted to initiate bowel contraction (peristaltic action) before expelling the contents to the last portion of the colon, ensuring that feces are only passed down during the irrigation process. The procedure enables patients to control their stoma and empty their bowels as scheduled daily, ensuring that they are free from frequent drainage. Colostomy irrigation ensures the cleanliness of the stoma and the patient’s body, increasing their comfort and self-esteem while interacting with other people (Boutry et al., 2021).(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

Health Promotion

Nurses should educate patients who have undergone a temporary colostomy to ensure that their colons heal appropriately without stress as they await a corrective surgery, such as fistula repair (El-Rahman et al., 2020). The most suitable health promotion teaching method for the patient is health talks, which involves naturally communicating to the patient and sharing knowledge about the best way to conduct colostomy irrigation (Tzenios, 2020). The nurse can use fliers, charts, and a pamphlet detailing the colostomy irrigation process (including a diagrammatic representation) to enhance the patient’s maximum understanding of the procedure.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

The patient in the case study, Mrs. Apolo, requires regular emptying of the bowel, which must be allowed to rest to allow for surgical repair of the rectovaginal fistula. Mrs. Apolo requires colostomy irrigation education to enhance personal care processes (Boutry et al., 2021). The nursing practice is suitable for Mrs. Apolo, who does not want to manage the colostomy bag fitted on the side. Colostomy irrigation will enable Mrs. Apolo to maintain hygiene and prevent infection, including performing daily chores like caring for the 2 and 4-year-old grandkids.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

Blood Work

The patient’s blood work indicates mild levels of potassium 3.4 mmol/L (mild hypokalemia) which can be treated with the administration of potassium supplements like oral potassium replacement therapy. Palaka et al. (2020) illustrate that failure to supplement potassium levels could contribute to potassium deficiency and increase the risk of hypertension, muscle weakness, and respiratory failure. Potassium deficiency could exacerbate the patient’s condition, resulting in poor health outcomes. Consequently, the patient’s white blood cell count was WBC 10.8 x10e9/L, indicating normal levels necessary for the body to fight against infections and bacteria. Casulleras et al. (2020) explain that nurses should regularly check the WBC levels to ensure that they are within normal ranges since higher levels beyond WBC 11x10e9/L could signify the presence of infection or inflammation, requiring immediate treatment to improve the patient’s health outcomes. Lastly, the patient is under IV Ampicillin 2g IV Q6H for four days to improve immune strength and reduce susceptibility to infection (Sy et al., 2022). The ostomy predisposes the patient to drug-resistant bacteria, like Staphylococcus aureus which could increase the risks of poor health outcomes, hence the need for ampicillin 2g IV Q6H injection.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

Colostomy Irrigation Process

The patient requires various equipment for colostomy irrigation, such as an irrigation kit, a hook, water-soluble lubricant, a dressing tray, a water cloth, a bath towel, and bedpans to collect the return flow. Colotomy irrigation involves five steps, including, first, closing the clamp on the tubing and filling the irrigation bag with approximately 4 cups of warm water (Cooper & Gosnell, 2022). Warm water is preferable to avoid cramps associated with cold water. The patient is then required to hang the bag on a hook above the toilet, with its bottom lining evenly with the shoulder when the patient is sitting on the toilet bowl and holding the bag’s tubing. Second, Cooper and Gosnell (2022) illustrate that the cap on the stoma is removed, and the skin around the stoma is cleaned with a soft cloth and warm water to remove any dirt or foreign particles that may cause infection. The patient is then expected to sit on the toilet and place the round opening of the sleeve around the stoma by pressing on the adhesive or attaching a mounting ring and fastening the belt while the other open end is placed over the toilet.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

Third, the cone is attached to the bag’s tubing, and lubricant is rubbed on its tip before inserting it into the stoma. A small amount of fluid is allowed to flow through the tube into the basin to ensure that all air bubbles are released from the set-up, which is necessary for preventing crampy pain experienced when air is introduced into the colon (Cooper & Gosnell, 2022). Afterward, the clamp in the tubing is opened slowly, allowing a gentle flow of water into the stoma for approximately 5-10 minutes before closing the clamp on the tubing (Cooper & Gosnell, 2022). Fourth, Cooper and Gosnell (2022) illustrate that the patient should wait for approximately 1 minute before removing the cone and sealing the top of the top of the sleeve while allowing water and stool to empty into the toilet through the sleeve for 15-20 minutes. After emptying all the contents, the patient is required to tidy the skin around the stoma by cleaning and drying it before covering the stoma with a cap. Boutry et al. (2021) explain that cleaning and drying the area around the stoma ensures patients’ comfort by eliminating any odor or pillage that occurs when detaching the sleeve. Lastly, the patient should clean the cone and sleeve by rinsing them with warm water mixed with vinegar, after which the sleeve should be hung to dry (Cooper & Gosnell, 2022).(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

Reflection

The nurse in charge can promote the recovery and health outcomes of the patient through the adoption of best practices and evidence-supported literature, which contain necessary guidelines for ensuring improved outcomes (Gallagher‐Ford et al., 2020). The best practice constitutes interventions, procedures, and techniques aimed at increasing the quality of care through informed decision-making and increasing skills like critical thinking, hence the nurse can use them to inform every step of care. Similarly, the evidence-supported literature constitutes evidence-based practices and a summary of procedures critical to daily nursing care (Gallagher‐Ford et al., 2020). Such information would help the nurse make vital care decisions, to ensure improved health outcomes.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

References

Boutry, E., Bertrand, M. M., Ripoche, J., Alonso, S., Bastide, S., Prudhomme, M., & of Ostomy, F. F. (2021). Quality of life in colostomy patients practicing colonic irrigation: An observational study. Journal of Visceral Surgery, 158(1), 4-10. (Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)https://doi.org/10.1016/j.jviscsurg.2020.07.003

Casulleras, M., Zhang, I. W., López-Vicario, C., & Clària, J. (2020). Leukocytes, systemic inflammation and immunopathology in acute-on-chronic liver failure. Cells, 9(12), 2632.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example) https://doi.org/10.3390/cells9122632

Cooper, K. & Gosnell, K. (2022). Foundations of nursing. (9^th ed., pp. 387-398). United States: Elsevier Health Sciences.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)

Cuzner, J. M. (2019). Colostomy irrigation: A client’s story about regaining control over her body. Journal of Stomal Therapy Australia, 39(4), 18-22. (Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)https://search.informit.org/doi/abs/10.3316/INFORMIT.840222277296938

El-Rahman, A., Ali, W., Mekkawy, M. M., & Ayoub, M. T. (2020). Effect of Nursing Instructions on Self Care for Colostomy Patients. Assiut Scientific Nursing Journal, 8(23), 96-105. https://dx.doi.org/10.21608/asnj.2020.48530.1066

Gallagher‐Ford, L., Koshy Thomas, B., Connor, L., Sinnott, L. T., & Melnyk, B. M. (2020). The effects of an intensive evidence‐based practice educational and skills building program on EBP competency and attributes. Worldviews on Evidence‐Based Nursing, 17(1), 71-81. https://doi.org/10.1111/wvn.12397

Palaka, E., Grandy, S., Darlington, O., McEwan, P., & van Doornewaard, A. (2020). Associations between serum potassium and adverse clinical outcomes: A systematic literature review. International Journal of Clinical Practice, 74(1). (Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)https://doi.org/10.1111/ijcp.13421

Sy, C. L., Chen, P. Y., Cheng, C. W., Huang, L. J., Wang, C. H., Chang, T. H., … & Wang, F. D. (2022). Recommendations and guidelines for the treatment of infections due to multidrug resistant organisms. Journal of Microbiology, Immunology and Infection, 55(3), 359-386.(Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example) https://doi.org/10.1016/j.jmii.2022.02.001

Tzenios, N. (2020). Clustering students for personalized health education based on learning styles. Sage Science Review of Educational Technology, 3(1), 22-36. (Patient Education on Colostomy Irrigation Comprehensive Nursing Essay Example)Retrieved from https://journals.sagescience.org/index.php/ssret/article/view/22