Introduction to postoperative nursing of urostomy

2021-10-19 管理员 Read 192

The position of urostomy is generally located in the right lower abdomen, which is a permanent stoma. There are many similarities between the nursing before and after urology and enterostomy, which can be carried out according to the method of enterostomy nursing, but urology still has some particularity, and several aspects should be paid attention to in nursing.


Postoperative evaluation


1、 Observation of urine


In the first 2 ~ 3 days after operation, the urine will be light red and then turn to normal light yellow. Because stoma is a segment of ileum with mesentery, this segment of intestine has the normal function of intestine and can secrete mucus. White flocs were found in postoperative urine bags, often mucus secreted by intestinal tubes. Mucus will be more and sticky after operation, and will gradually decrease after the ureteral stent is pulled out.


Pay attention to whether the urine flows out smoothly from the two ureteral stents. If there is blood clot obstruction, report it in time;


Observe and record the excretion of urine. If there is little or no urine, report to the doctor in time.


2、 Observation of drainage fluid


After the operation, the abdominal drainage tube shall be retained, the pipeline shall be fixed and the drainage tube shall be kept unobstructed. Pay attention to the color of the drainage fluid. The color may be light red and the amount may gradually decrease. If the color of the drainage fluid is the same as that of the urine, seek the help of a professional doctor in time to judge whether it is intestinal anastomotic leakage.


3、 Pocket making options


The selection principle of urinary bag is that the urinary bag can store urine and must have an anti reflux device. At the same time, the lower end of the urinary bag is equipped with a piston valve to facilitate the sealing of the urinary bag and the discharge of urine.


In the early stage of operation, two-piece pocket should be selected to facilitate the cleaning of mucus discharged from stoma; When the mucus is reduced, one-piece or two-piece bags can be selected.


4、 Nursing precautions


The best time to replace the bag is after getting up in the morning, so the urine volume is less and easy to replace.


Clean the area around the stoma and directly use clean water or cool it! Do not use disinfectant or iodophor and other organic solutions to clean the stoma and surrounding skin, so as not to stimulate the stoma and cause dry skin.


When replacing the bag body, a dry cotton ball can be placed on the stoma to absorb urine to prevent wetting the surrounding skin


Urostomy will have mucus secretion, especially in the early stage after operation. It should be cleaned frequently to avoid blocking the discharge of urine.


5、 Other frequently asked questions


1. Prevent urine odor


It is recommended to avoid eating food that is easy to produce odor. Such as asparagus, fish and spices will increase the odor of urine; Similarly, some drugs also affect the taste of urine. Cranberry juice, cheese and buttermilk can help reduce peculiar smell.


2. Prevention of urinary tract infection


Drink as much water and fruit juice as possible every day, and the amount of drinking water should reach 1500ml ~ 2000ml;


Eat more fresh vegetables and fruits rich in vitamin C, because vitamin C is helpful to prevent urinary tract infection.


Make pockets with anti backflow devices.


Empty the bag regularly, and discharge it when 1 / 3 ~ 1 / 2 of the bag is full. When sleeping at night, a large capacity urine collection bag can be connected to avoid getting up frequently.


3. Complications - urinary crystallization


If white powder crystals adhere to the stoma or the skin around the stoma, clean the stoma and the crystals around the stoma with white vinegar (the volume ratio of vinegar to water is 1:3), and then clean the stoma and the skin around the stoma with clean water. At the same time, drink plenty of water, 2 ~ 3 liters a day; Take vitamin c1000mg every day and eat more acidic food to make the urine acidic.


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