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Ministry of health of ukraine

Kharkiv National Medical University

 

Approved

on the methodical meeting Department of Oncology

Head of Department

MD, Professor VI Starikov

"30" August 2012

 

 

 

A methodical DEVELOPMENT

Students Course VI

Faculty of Medicine

 

 

Topic 1. Emergency in Oncology

Theme 2. Emergency treatment for complications of chemotherapy and radiotherapy

Theme 3. Treatment of complicated forms of cancer

Theme 4. Palliative surgery

 

 

 

 

 

 

 

 

Kharkiv December 2012

 

 

CARE OF PATIENTS WITH STOMA

Various stoma (artificial breeding hole hollow organ to the skin) are common in cancer patients, among them distinguished: manger stoma (for food) - Gastrostomy, enterostoma; excretory stoma - Colostomy, enterostoma, cystostomy, nefrostoma; breathing - Tracheostomy. Also, sometimes used artificial exterior fistula: bile, pancreatic, pleural. Any stoma significantly affects the lifestyle of the patient, significantly degrading its quality, so the organization proper care of patients enables to provide a higher level of consumer and social adaptation.

Special attention should be given to ensure control over the stoma, getting rid of extraneous emissions and odor and skin care.

If Tracheostomy skin care by using protective fatty emollients creams, provides permanent removal of sputum using disposable napkins. Traheostomu can cover the gauze bandage, hidden behind a high collar or cervical scarve.

Gastro-or enterostoma well hidden under clothes, but need serious skincare that undergoes the annoying effects of gastric or intestinal contents. The skin of the stoma should be regularly washed with warm soapy water, process cushioning prtyzapalnymy ointments and creams and cover with a layer of protective ointment. Frequently changing dressings to avoid inflammation and foreign smell.

The basis for the care of colostomy in the abdominal wall is a correct application of the most suitable in each case kalopryyomnyka. Various modern models kalopryyomnykiv allow enough acceptable level of quality of life and social activities of patients. Very important to the skin around the colostomy hygiene: wash with warm water and soap, anti-inflammatory creams and ointments mazove protective coating.

It is advisable to respect a special diet for prevention of diarrhea and a more dense consistency of feces. Contribute to this: cooked rice, pasta, potatoes, white bread, bananas, apple juice and cheese. On the contrary, beer and alcoholic drinks, fruit juices, mineral water, beans, peas, fresh vegetables and fruits, kofeyinutrymuyuchy drinks, spices, spicy food, dairy products, nuts, chocolate - and promote gasification of diarrhea.

If urinary stoma most problems related to ensuring integrity, preventing leakage of urine and prevention of infection. Having a permanent catheter in the bladder can lead to cystitis, accompanied by hematuria and ascending infection. To prevent cystitis bladder regularly (after 1-3 hours), washed with antiseptic solutions (furatsillin, betadin) prophylactically administered uroseptics (tsyston, Nitroxoline, furadonin etc.). The required constant monitoring catheter maneuverability, regular cleaning and, if necessary, replacement. In order to timely diagnosis of infection in 2-3 days performing urine. It is also necessary skin protection and care by mazovyh dressings.

Important role played by the general nursing: creating the conditions for independent personal hygiene; understanding of the patient and sensitive attitude towards them; regular bath, shower, toilet or total body in bed, ventilate the room and use deodorant. Experience shows that with proper care of stoma patients can fully adapt to the new environment and maintain an active lifestyle.

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