You finish your general head-to-toe assessment and order the appropriate pouching products for d.s. Youtake clean towels, washcloths, and underpads into his room, along with a hamper to receive dirty, usedlaundry
You gather scissors, skin-Prep, and adhesive remover to assist with the pouching change.
As you return to his room, you review the steps for changing an ostomy pouch. What are the
steps you will need to follow?
• Only cut the hole in the wafer 1?8-inch larger than the stoma. Do not cover the stoma with the wafer;
this will create a track for the stool and urine to leak under the wafer. Do not cut the hole too large,
leaving exposed skin, or the stool and urine will cause tissue breakdown. A pattern can be made of
the stoma on paper then traced onto the wafer; then cut to that size.
• Apply the wafer to a clean, dry surface. This is a clean, not sterile, process. Wash with plain soap
and water. Use soap without oils, lanolin, or fragrance.
• Completely dry the tissue, but gently. Use patting and air exposure to dry while you cut the stoma
size in the wafer.
• When placing the wafer, you can gently pull and stretch the abdomen upward to help create a flat
surface for attachment.
• Have the patient hold a hand over the pouching system for 5 to 15 minutes. The warmth of the
patient's hand will allow the wafer to adhere to the skin. After you place the wafer over the stoma,
gently run your finger over the wafer, next to the stoma, to assist the adhesive seal and remove air
bubbles—you do not have to use a great deal of pressure.
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