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5.2.1. Preparation stage:

At the beginning of class, the instructor introduces students to the basic tasks of occupation plan. To control the output level of knowledge of students each proposed to solve a test with 10 questions.

5.2.2. Main stage: care 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.

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.


Ascites - abnormal accumulation of free fluid in the abdomen (often) occurs as a result of the following reasons: kantseromatoz peritoneum, retroperitoneal lymph node metastatic lesions, accompanied by violation of lymph, hypoalbuminemia, profound violation salt obinu (as a consequence of high levels of aldosterone) supporting cardiogenic pathology.

Clinical manifestations of ascites depends on the amount of free fluid: increased abdominal discomfort in the abdomen, feeling of fullness, indigestion, belching, reflux, nausea and vomiting, shortness of breath, swelling of the lower extremities.

Conservative treatment of ascites include application specific anticancer chemotherapy (including intravenous, intraperitoneal or endolymphatic) treatment of accompanying diseases, if it is the cause of fluid accumulation, use of diuretics.

In cases when conservative therapy is ineffective, requires evacuation of fluid through celiocentesis. This surgical manipulation should be carried out in strict accordance with the principles of asepsis and antisepsis, a doctor who has relevant experience. After manipulation morning nakladuyetsya bandage and, in most cases, to prevent leakage of ascitic fluid - seam. The bandage should be kept until they are healed. In principle, it is possible and permanent drainage of the abdominal cavity, but in practice it is rarely used, often performing repeated puncture of the abdominal cavity. Treatment of ascites does not require adherence to a special diet, with some restrictions salty foods. No need to control and fluid intake. Eating should be smaller portions, but more often.

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