A nurse is providing teaching to a client who has a new colostomy.
Which of the following actions should the nurse take when demonstrating how to change the ostomy appliance?
A.
Apply the skin sealant on damp skin.
B.
Remove the appliance before emptying the pouch.
C.
Ensure that the skin is slightly damp for better adhesion of the pouch.
D.
Trace the size of stoma onto the skin barrier.
The correct answer and Explanation is :
The correct answer is D. Trace the size of the stoma onto the skin barrier.
Explanation:
When teaching a client how to change their ostomy appliance, it is crucial to ensure proper fit and adhesion to protect the skin and provide comfort. The steps include measuring the stoma to cut the opening of the skin barrier to the correct size, ensuring the appliance adheres securely without restricting the stoma or causing damage.
- Tracing the stoma size: Stomas change in size, particularly in the initial weeks following surgery, so the nurse should teach the client to trace the size of the stoma onto the skin barrier to ensure a proper fit. A barrier that is too tight can irritate the stoma, while one that is too loose may expose the surrounding skin, leading to leakage and skin irritation.
Why the other options are incorrect:
- A. Apply the skin sealant on damp skin: Skin sealant or adhesive should always be applied to clean, dry skin. Moisture can interfere with the adhesion of the appliance, leading to leakage and skin breakdown.
- B. Remove the appliance before emptying the pouch: The pouch should be emptied when it is about one-third to one-half full, without removing the appliance. Removing the appliance each time it is emptied would cause unnecessary trauma to the skin and reduce the appliance’s effectiveness.
- C. Ensure that the skin is slightly damp for better adhesion: This is incorrect because the skin needs to be dry for the adhesive to bond properly. Damp skin can cause the adhesive to break down more quickly, leading to leaks and skin irritation.
In summary, tracing the stoma size onto the skin barrier is essential for ensuring a good fit, promoting comfort, and preventing complications like skin irritation or leakage.