Urinary Diversion Stoma Care

Urinary Diversion Stoma Care

Urinary diversions provide an alternative route for urine flow when a disorder, such as an invasive bladder tumor, impedes normal drainage. A permanent urinary diversion is indicated in any condition that requires a total cystectomy. In conditions requiring temporary urinary drainage or diversion, a suprapubic or urethral catheter is usually inserted to divert the flow of urine temporarily. The catheter remains in place until the incision heals.

Urinary diversions may also be indicated for patients with neurogenic bladder, congenital anomaly, traumatic injury to the lower urinary tract, or severe chronic urinary tract infection.

Ileal conduit and continent urinary diversion are the two types of permanent urinary diversions with stomas. (See Types of permanent urinary diversion, page 770.) These procedures usually require the patient to wear a urine-collection appliance and to care for the stoma created during surgery. Evaluation by a wound ostomy continence nurse will facilitate site selection and postoperative stoma care.

Preparation of Equipment

Gather all the equipment on the patient’s overbed table. Tape the waste receptacle to the table for ready access. Provide privacy for the patient, perform hand hygiene1,2,3 and follow standard precautions. Measure the diameter of the stoma with the measuring guide. Cut the opening of the appliance with the scissors—it shouldn’t be more than 1/8″ to 1/6″ (0.3 to 0.4 cm) larger than the diameter of the stoma. Moisten the faceplate of the appliance with a small amount of water or liquid skin sealant to prepare it
for adhesion
. Performing these preliminary steps at the bedside allows you to demonstrate the procedure and show the patient that it isn’t difficult, which will help him relax.

Jul 21, 2016 | Posted by in NURSING | Comments Off on Urinary Diversion Stoma Care

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