The nurse is caring for a patient with a urinary stoma. In which order should the nurse provide care?

Question

Choice 1. Cleanse the skin around stoma with soap and water, rinse, and pat or air-dry.
Choice 2. Assess the stoma, noting color and moisture.
Choice 3. Remove the old pouch; use warm water to loosen the seal.
Choice 4. Use the stoma guide to determine the size of the bag opening and/or protective ring. Trim as needed.
Choice 5. Apply the bag with an opening no more than 1–2 mm wider than the outside of the stoma.
Choice 6. Apply a skin barrier; allow the skin to dry, then connect the bag to the urine-collection device.

Answer 1

Correct Answer: 3, 2, 1, 4, 6, 5
Care of a urinary stoma includes removing the old pouch by gently pulling it away from skin. Warm water or adhesive solvent may be used to loosen the seal if necessary. Then the nurse assesses the stoma, noting color and moist appearance. Urine flow may be prevented by placing rolled gauze or a tampon over the stoma opening. Then the nurse cleanses the skin around the stoma with soap and water, rinses, and pats or air dries. In the fourth step, the nurse uses the stoma guide to determine the correct size of the bag opening and/or protective ring. The bag or seal is trimmed as needed. The nurse then applies a skin barrier and allows the skin to dry. In the last step, the nurse applies the bag with an opening no more than 1–2 mm wider than the outside of the stoma. The bag is connected to the urine-collection device; the old bag, used supplies, and gloves are disposed of. The nurse then charts the procedure.