Colostomy Irrigation

1. COLOSTOMY IRRIGATION
8/30/2020 Darwina I Halbi MAN 1
Prepared By
DARWINA IRIBANI HALBI RN MAN
Ateneo De Zamboanga University
Zamboanga City Philippines

2. COLOSTOMY IRRIGATION
8/30/2020 Darwina I Halbi MAN 2

3. COLOSTOMY IRRIGATION
• Colostomy irrigation is a way to regulate
bowel movements by emptying the colon at
a scheduled time
• The process involves infusing water into the
colon through the stoma. This stimulates the
colon to empty. By repeating this process
regularly— once a day or once every second day
— the colon can be trained to empty with no
spillage of waste in between irrigation.
• Colostomy irrigation also can help avoid
constipation.
8/30/2020 Darwina I Halbi MAN 3

4. COLOSTOMY IRRIGATION
Objectives
• To empty and cleanses the colon and
rectum
• To stimulate peristalsis and help
develop regular bowel movement.
• To relieve flatulence.
8/30/2020 Darwina I Halbi MAN 4

5. COLOSTOMY IRRIGATION
Indications
• Accomplished after surgery to promote
regulated evacuation.
• To regulate bowel movement
• To help avoid constipation
8/30/2020 Darwina I Halbi MAN 5

6. COLOSTOMY IRRIGATION
• Nursing Alert:
The danger of the perforation of the colon is
much greater when irrigating a colostomy with a
catheter. The use of an irrigation cone usually
results in safer administration and better water
flow.
8/30/2020 Darwina I Halbi MAN 6

7. COLOSTOMY IRRIGATION
• Equipment can be kept at the patient’s
bedside or in the bathroom.
• Irrigation kit (irrigation bag with clamp
and tubing, cone-tip irrigation catheter,
irrigation drain pouch).
• Water soluble lubricant.
• IV pole (or other suspending hook).
• Draw Sheet or CHUX
8/30/2020 Darwina I Halbi MAN 7

8. COLOSTOMY IRRIGATION
• Equipment can be kept at the
patient’s bedside or in the bathroom.
• Soap and water.
• Washcloth and towel.
• Ostomy appliance
• Waste receptacle.
• Prescribed irrigating solution, usually
500-1000cc warm (100º–105ºF) tap
water.
8/30/2020 Darwina I Halbi MAN 8

9. Nursing responsibilities before the procedure
• Verify patient’s identity.
• Introduce self. 2.
• Explain procedure to the patient.
• Gather Equipment
• Practice Hand hygiene. Don gloves.
• Provide Privacy
8/30/2020 Darwina I Halbi MAN 9

10. Nursing responsibilities before the procedure
• If the patient is ambulatory, have the patient
sit on the toilet or on a chair facing the toilet. If
the patient is bedridden, elevate the HOBº 45-
90ºand position Chux around the patient.
8/30/2020 Darwina I Halbi MAN 10

11. DURING THE PROCEDURE
• 1. Fill the irrigation bag with the prescribed
solution and hang it on the IV pole or hook.
• (a.) The bottom of the bag should be at the
patient’s shoulder level when he is seated to
prevent fluid from entering the bowel too
rapidly.
• (b.) The bottom of the bag should be placed 18
to 20 inches above the stoma when the patient
is in bed.
8/30/2020 Darwina I Halbi MAN 11

12. COLOSTOMY IRRIGATION
• 7. Open the clamp on the irrigation tubing
and allow the solution to fill the tubing.
Reclamp.
• (This prevents the administration of air into
the intestines.To release air bubbles in the set-
up so that air is not introduced into the colon
which would cause crampy pain.)
8/30/2020 Darwina I Halbi MAN 12

13. COLOSTOMY IRRIGATION
• 8. Prepare to begin the colostomy irrigation.
• a. Remove the ostomy pouch, if applicable,
and place the irrigation drain pouch over the
stoma. (Attach stoma belt if required.)
• b. Place the bottom, open end of the
irrigation drain pouch in the toilet (or bedpan)
to facilitate drainage by gravity.
• c. Connect the cone-tip catheter to the tubing
and flush with solution.
8/30/2020 Darwina I Halbi MAN 13

14. COLOSTOMY IRRIGATION
• 9. Lubricate the cone with the water-soluble
lubricant to avoid irritating the mucous
membranes.
8/30/2020 Darwina I Halbi MAN 14

15. COLOSTOMY IRRIGATION
• 10. Gently insert the cone into the stoma so that
the stoma is occluded. Unclamp the irrigating
tubing and allow the water to flow in slowly
• a. Allow water to enter the colon over a period of
10 to 15 minutes.
• b. If cramping occurs, slow down the flow rate
and ask patient to deep breathe until cramps
subside. Cramping during irrigation may indicate
that:
• (b.1) The bowel is ready to empty.
• (b.2) The water is too cold.
• (b.3) The flow is too fast.
8/30/2020 Darwina I Halbi MAN 15

16. COLOSTOMY IRRIGATION
• 11. Clamp the catheter and remove from the
stoma. Fold down the top opening of the
irrigation drain pouch and secure it in the
closed position.
• 12. Have the colostomy patient sit on or near
the toilet for about 15 to 20 minutes so the
initial colostomy returns can drain into the
toilet. (If the patient is on bed rest, allow the
colostomy to drain into the bedpan.)
8/30/2020 Darwina I Halbi MAN 16

17. COLOSTOMY IRRIGATION
• 13. Close the colostomy irrigation drain pouch
with a rubber band or pouch clip, then
ambulate the patient, or return him/her to
bed.
• a. Ambulating stimulates elimination,
producing improved irrigation return.
• b. Have the non-ambulatory patient lean
forward or massage his/her abdomen to
stimulate return.
8/30/2020 Darwina I Halbi MAN 17

18. COLOSTOMY IRRIGATION
• 15. Gently clean the area around the stoma
with mild soap and water.
• a. Be careful not to rub the skin.
• b. Rinse and dry the area with a towel.
8/30/2020 Darwina I Halbi MAN 18

19. COLOSTOMY IRRIGATION
• 16. Provide for the patient’s comfort; remove
and dispose of used supplies.
• Return the equipment to the utility room,
clean and return to the proper place. This
will control odor and prolong life of the
equipment.
8/30/2020 Darwina I Halbi MAN 19

20. AFTER COLOSTOMY IRRIGATION
• 17. Document findings
• a. Record the procedure and significant
nursing observations in the patient’s clinical
record and report it to charge nurse.
• 1) Note color and condition of stoma and
peristomal skin.
• 2) Record color, consistency, and amount of
drainage.
• 3) Note amount of irrigating solution used.
8/30/2020 Darwina I Halbi MAN 20

21. COLOSTOMY IRRIGATION
• 18. As recovery progresses, the nursing
personnel should gradually assume a more
passive role in colostomy care, allowing the
patient to assume the active role.
8/30/2020 Darwina I Halbi MAN 21

22. COLOSTOMY IRRIGATION
8/30/2020 Darwina I Halbi MAN 22