Colostomy Irrigation Nursing Procedure and Interventions

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.

Objectives

To empty and cleanses the colon and rectum
To stimulate peristalsis and help develop regular bowel movement.
To relieve flatulence.

Indications

Accomplished after surgery to promote regulated evacuation.
To regulate bowel movement
To help avoid constipation

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.

Equipment

Enema can and tubing
three emesis basins
bath blanket
warm water in a basin
bath towel
bedpans or pail for collecting the return flow
irrigating solution
Newspaper
Also: soap, extra rubber sheet, small colon tube, plastic apron, colostomy dressing tray, wash cloth.

Nursing Care Plans

Main Article: 10 Ileostomy & Colostomy Nursing Care Plans

Nursing Interventions & Rationale

Nursing Interventions	Rationale
Explain the procedure to the patient.	To gain the cooperation of the patient.
Wash hands.	To avoid contamination.
Bring equipments to the bedside and provide privacy.	To save time and promote the dignity of the patient.
Assist the patient to turn on his left side or appropriate side.	To allow the nurse to do the procedure without difficulty.
Place the emesis basin and newspaper at the foot of the bed.	To ensure that the waste are properly disposed.
Expose the abdomen, drape the patient with a bath blanker if necessary.	Draping is also part in the provision of the patient’s privacy.
Remove soiled dressings and place them on the emesis basin and newspaper at the foot of the bed.	To avoid contamination and control odor.
Place the basin for return flow immediately under the colostomy opening. The patient can hold this in place if he is able.	Basin must be ready to avoid spillage.
Open the clamp on the tubing and allow a small amount of solution to flow into the basin.	To release air bubbles in the set-up so that air is not introduced into the colon which would cause crampy pain.
Lubricate the tip of the colon tube.	To facilitate the easy insertion of the tube.
Insert the colon tube 6-8 inches into the colostomy opening.	To avoid irrigating the intestinal mucosa..
Hold the enema can approximately 12 inches above the bed and allow the solution to flow in slowly.	To avoid painful cramp usually caused by too rapid flow.
When the basin is almost full, quickly remove it and place the second basin in position.	To avoid spillage.
Empty the first basin immediately	So that it will be ready for use if needed again.
After the irrigation is finished, wash the area with soap and water and apply a clean dressing to the area.	Cleanliness and dryness will provide the patient with comfort.
Return the equipment to the utility room, clean and return to the proper place.	This will control odor and prolong life of the equipment.

Charting

Time irrigation administered
Kind and amount of solution used for the irrigation.
Dressing applied.
Condition of the area.
Results obtained; amount,color, and consistency of the returns.
Patient’s reaction to procedure.