Stoma

Definition

A stoma is a surgically created opening where a portion of the bowel or urinary tract is brought to the surface of the abdomen. Waste passes through the stoma into a pouch.

Types

• Colostomy: Colon to skin
• Ileostomy: Ileum to skin
• Urostomy: Urinary diversion via ileal conduit

Stoma Assessment

• Normal: Pink/red, moist, slightly protrudes 1 to 3 cm.
• Abnormal: Dusky, purple, or black. Ischemia/necrosis, notify surgeon!
• Pale = anemia.
• Bleeding: small is normal; copious needs reporting.

Patient Teaching

• Empty pouch when 1/3 full
• Change system every 3 to 7 days
• Clean peristomal skin with water (no soap residue)
• Use skin barrier to protect surrounding skin
• Cut barrier to fit stoma shape
• Provide emotional support; encourage connection with ostomy support groups

NCLEX Relevance

Dark stoma = emergency (ischemia).