Colostomy Irrigation
Irrigation of a colostomy can serve two purposes: It allows a patient with a descending or sigmoid colostomy to regulate bowel function, and it cleans the large bowel before and after tests, surgery, or other procedures.
Colostomy irrigation may begin as soon as bowel function resumes after surgery. However, most clinicians recommend waiting until bowel movements are more predictable. Initially, the nurse or the patient irrigates the colostomy at the same time every day, recording the amount of output and any spillage between irrigations. Between 4 and 6 weeks may pass before colostomy irrigation establishes a predictable elimination pattern.
Colostomy irrigation is contraindicated in patients with bowel disease, irritable bowel syndrome, or severe heart or kidney disease.
Equipment
Colostomy irrigation set (contains an irrigation drain or sleeve, an ostomy belt [if needed] to secure the drain or sleeve, water-soluble lubricant, drainage pouch clamp, and irrigation bag with clamp, tubing, and cone tip) ▪ 1,000-mL (1 quart) of tap water irrigant warmed to about 105°F (40.6°C) ▪ IV pole or wall hook ▪ washcloth and towel ▪ water ▪ ostomy pouching system ▪ linen-saver pad ▪ gloves ▪ Optional: bedpan or chair, clip, small dressing or bandage, stoma cap.
Preparation of Equipment
Set up the irrigation bag, tubing, and cone tip. If irrigation will take place with the patient in bed, place the bedpan beside the bed and elevate the head of the bed between 45 and 90 degrees, if allowed. If irrigation will take place in the bathroom, have the patient sit on the toilet or on a chair facing the toilet, whichever he finds more comfortable.
Fill the irrigation bag with warmed tap water. Hang the bag on the IV pole or wall hook. The bottom of the bag should be at the patient’s shoulder level to prevent the fluid from entering the bowel too quickly. Most irrigation sets also have a clamp that regulates the flow rate.
Prime the tubing with irrigant to prevent air from entering the colon and possibly causing cramps and gas pains.
Implementation
Verify the doctor’s order.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Explain every step of the procedure to the patient because he’ll eventually be irrigating the colostomy himself.
Provide privacy.
If the patient is in bed, place a linen-saver pad under him to protect the sheets.
Remove the ostomy pouch if the patient uses one.
Place the irrigation sleeve over the stoma. If the sleeve doesn’t have an adhesive backing, secure the sleeve with an ostomy belt. If the patient has a two-piece pouching system with flanges, snap off the pouch and save it. Snap on the irrigation sleeve.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
