Transcription of Nutrition and Elimination
1 Ostomy CareNormal urination and bowel Elimination is not possible for everyone due to aging and certain disease or health condi-tions. Some residents may have had an ostomy, which is a surgical procedure that creates an opening in the body for the discharge of wastes. Ostomies can be done to divert a resident s urine (urostomy or ureterostomy) or stool (colos-tomy or ileostomy). The opening is called the stoma . The stoma is normally red and has a round shape. Immediately after surgery , the stoma may be swollen. After surgery , the stoma is measured for fitting the proper pouching system. In many cases, this is the resident s permanent method of Elimination (Figure 6-5).Many residents who have undergone ostomy proce-dures are very sensitive and concerned about how others perceive them.
2 They may be afraid of being avoided or treated differently. Always maintain a positive attitude and treat the resident with respect and dignity. Be careful to avoid any facial expressions or comments that may be interpreted as offensive. Is the appliance leaking? Is the seal around the stoma secure? Is the ostomy draining well? Are the consistency and color of the stool or urinenormal? Are the stoma and surrounding skin intact? Is there redness, bleeding, or other type of skinbreakdown?Figure 6-5 Following an ostomy procedure, a special bag (pouch) is used to collect waste excreted from the CareFollow your facility s policies and procedures for ostomy care. Many residents do their own care independently.
3 They may only need you to provide supplies. How much support you give depends on the resident s level of with all residents, pay attention to any changes in Elimination patterns. Observe the stoma for changes. Because the stoma has a rich blood supply, it will bleed easily if irritated or injured. Even when injured, the resident will not feel pain or other sensations in the stoma because no nerve endings are present there. The skin around the stoma must be protected from digestive enzymes, which can cause irritation. Observe the skin around the stoma for any signs of irritation, and report any problems to the charge nurse. The exact care you give depends on the resident s needs, direction from the charge nurse, and the care residents with an ostomy use a bag device called an appliance or pouch.
4 Your observations while providing care are very important. When helping a resident with dressing, undressing, or bathing, take time to observe the appliance and the resident s skin. Look for the following:1 Nutrition and EliminationThe urine of diabetic residents may need to be checked for ketones (acetone). This test may also be done for a resident with a change such as increased urine output. When the body burns fat, ketones may be present in the urine. This test is done early in the morning before the resident eats. After dipping the test strip in urine, you compare it to the color chart on the test strip container. Some strips use + and symbols instead of color changes to show the presence or absence of SpecimensStool specimens help physicians diagnose gastrointestinal problems.
5 They may also be collected to check for parasites that can make a resident sick. Bleeding in the gastrointestinal tract may be visible or invisible. Occult blood is not visible to the human eye. Visible blood in the stool may be bright red or may make the stool look black and sticky (called tarry stool), depending on the source of the bleeding. Stool specimens may be tested for occult blood at the facility or may be sent to a lab for an Ostomy BagYou may be asked to empty and measure the contents of a resident s ostomy bag (Figure 6-6). When emptying an ostomy bag, follow these guidelines: Always wear gloves. Measure the contents of the bag at least once during ashift. To empty the bag, undo the clip on the bottom of thebag, and empty the contents into a bedpan.
6 Some bags do not have clips and must be changed aftereach use. Know the appliance your resident uses and howto empty it. Rinse out the bag each time you empty it. You may use alarge irrigation syringe. Add a deodorizer if needed. Wipe off the end of the bag. Reseal the bag with the 6-6 Be sure to read and follow the manufacturer s directions for emptying and changing an ostomy bag. 2 DISCLAIMER: AHCA/NCAL has created this course to assist providers to recruit and train temporary staff during the national emergency caused by the coronavirus pandemic. Federal and/or state requirements may need to be waived to permit individuals under this training program in your location. Employers should check with their state survey agencies and their state occupational licensing agencies where applicable to ensure individuals trained under this program are permitted to assist with care in your location.
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