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In this video, we’re going to talk about stoma care. Now, the wafer and bag for an ostomy only NEEDS to be changed every 3 days, or if it’s leaking. But, you still need to be able to assess the stoma itself. In this case we’re going to show you how to replace the bag and clean and assess the stoma. Start by putting a towel under the patient on the side of the stoma.The first thing you want to do is assess the output from the stoma. If you have a clear bag, you can visualize it that way, otherwise you’ll need to empty the bag into a urinal so you can measure it, then discard in the toilet.In order to clean and assess the stoma, we have to remove the bag. You’ll start by peeling the wafer and pushing the skin down away from it. You may need to use warm water or alcohol here if the adhesive is tough.Now you want to clean the stoma and around it with a washcloth with warm soapy water. Use gentle strokes, don’t scrub.Then you will pat the skin dry with a towel. Again, don’t rub.Now that it’s clean, you can inspect the stoma itself. It should be light to dark pink and moist. What you don’t want to see is dark red, pale, purple, or blue-ish - none of those are good signs, they all represent problems with perfusion and should be reported right away. And of course, look for any skin breakdown.Now you’re going to measure the stoma and cut the hole of the wafer to be about ⅛ inch larger than the stoma. You’ll apply skin prep or barrier to the skin around the stoma, remove the paper backing from the wafer, and apply it to the skin with the stoma in the center of the hole.If you get any spaces or creases you can’t smooth out, you can use barrier paste to fill them in.If you’re using a 2-piece, you’ll apply the wafer first and then snap on the bag. Then make sure the bag is closed and sealed based on the type of bag you have.Discard your supplies, wash your hands, and document your findings, including the output measurement. So that’s it for stoma care - remember the little things might change depending on the type of stoma your patient has and what kind of device you’re using. But always look at the stoma and the skin around it.Now, go out and be your best self today. And, as always, happy nursing!
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