Question

A client with a recent colostomy expresses concern about the ability to control flatus. Which intervention is most important for the nurse to include in the client's plan of care?

Answer 1

The most important nursing intervention for a client with a colostomy concerned about flatus control includes education and helping adjust the ostomy appliance, understanding changes in anatomy, and diet management to reduce gas production.

Step-by-step explanation:

For a client with a colostomy, concerns about controlling flatus are common. The most important intervention for a nurse to include in the client's plan of care involves education and adjustment of the ostomy appliance. Since feces are eliminated through contractions of the rectal muscles, and individuals can typically assist with the process voluntarily using the Valsalva's maneuver, the anatomy after colostomy changes this process.

After a colostomy, gas and feces will now exit through the stoma and are collected in an ostomy appliance, or bag, which is adhered to the client's skin. Controlling gas and odor is a concern for many clients, and modern pouches often come with filters that help to deodorize and slowly release gas, reducing embarrassment for the individual. Adjusting diet to avoid gas-producing foods and ensuring a secure fit of the ostomy appliance to prevent leaks is also crucial.

In cases where ileostomy is necessary, the watery chyme from the distal ileum is collected into a bag-like adhesive appliance on the outside of the abdomen. Although controls like the Valsalva's maneuver are not applicable here, proper care and management of the appliance is vital for maintaining quality of life.