Need info on Colostomy

[wearingmanyhats, RN]

I am an agency LPN, and the one LTC that I go to frequently, there is a very obtund woman who has a history of bowel obstruction and after several hospitalizations, she was given a colostomy....

My question.... her stoma often has a protrusion that appears like a uterine prolapse.... it is as big as my 2 fists together, and it takes a lot to reduce it enough to place the appliance...

My biggest concern though, it the fact that because it is so big, the appliance cannot be placed as close to the edges of the stoma so that it protects the intact skin, and yesterday, I noticed that the edges are bleeding...

The agency RN's that I have worked with (They do not have an RN on staff for either 3-11 or 11-7 ....) just reduce it an place the appliance, but I am thinking that this in NOT normal???

any info will be appreciated...

Faye

[MoopleRN]

No, this is NOT normal. I'm not sure I understand when you say they "reduce" the "protrusion". Do you mean they push it back into the stoma?!?!?

[NRSKarenRN, BSN, RN]

from memphis area wocn:

[color=#333399]stomal complications

[color=#333399]by diane harville rn cwocn

[color=#333399][color=#333399][color=#333399]nursing intervention: [color=#333399]

[color=#333399]initial intervention for prolapse should be to attempt to reduce the stoma by gently pushing the prolapsed segment back into the abdomen.

[color=#333399]

[color=#333399]includes pictures prolapse![color=#333399]

somtimes placing little ring of stomapaste at base of protrusion , reducting protrusion then applying appliance works as allows flange a cushion to ride against when moving around in bed. othertimes little a+d ointment to proplase outer area protects skin from rubbing against wafer edge. if mobile wearing an appliance belt helps.

ask for wocn eval if significant concerns.

[wearingmanyhats, RN]

Thanks.... that was initial thought... that this is NOT normal, and that we should seek an eval... will put the request in when I am back there . Thanks for your help!