What is a urostomy? Simply a diversion of urine from the bladder to an opening (stoma) in the abdomen. The stoma can be a single diversion or a double barrel with two openings , one for each kidney. Why is a urostomy created? Obstruction (i.e.malignancy), birth defect causing chronic reflux and infection, neurologic abnormalities , chronic bladder inflammation What are the types of urostomies? Continent or incontinent (standard) What is a continent ostomy? An internal pouch that will be drained 4-5 times daily with a catheter. Best known as Indiana or Kock's pouch. Both are made from sections of the terminal ileum What is a standard ostomy? The patient will have a stoma which drains directly into an external pouch/ collection system How is a standard pouch cared for The skin surrounding the pouch requires meticulous nursing care as urine is acidic and will excoriate the skin making an appliance painful. Stoma plates for urostomies are cut 1/8 larger than the actual stoma, until approx 6 months when a standard appliance can be used. How often is the faceplate changed. Approximately every 3-5 days What factors affect the faceplate adherence? Sweating, physical activity, extreme weight loss or gain, environmental changes, i.e. humidity How is the skin under the faceplate protected Barrier cream applied with each faceplate change will protect the peristomal ( area around the stoma) skin. If the faceplate opening is too small, it may impede blood flow to the stoma. If the opening in the faceplate is too large, there will be leakage and excoriation of skin with resulting breakdown . What are some common Nursing Diagnosis to consider with ostomies? Skin intergrity, Impaired or risk for/ Body Image , disturbed/ Risk for Infection/ Social Isolation/ Knowledge Deficit/ Self Esteem/ Self-Care Deficit, Toileting/ Self Esteem, situational low Where can patients be directed for teaching? Most institutions have an ET (Enterostomal Therapist) Nurse or Ostomy Nurse who specialize in Ostomy care and Teaching. Another great referral is the UOAA United Ostomy Association America. basic urostomy information
Urostomies 
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