You have to teach ostomy self-care to a patient with a colostomy. You tell the patient to measure and cut the wafer:
A. To the exact size of the stoma.
B. About 1/16” larger than the stoma.
C. About 1/8” larger than the stoma.
Incorrect
Correct Answer: B. About 1/16” larger than the stoma.
A proper fit protects the skin but doesn’t impair circulation. A 1/16” should be cut. After the stoma has been measured, the patient will need to cut an opening that matches the measurement on the back of the barrier. If a one-piece pouch is being used, be sure to pull the pouch away to prevent cutting into the plastic. The opening should match the size of the stoma leaving no exposed skin.
Option A: Not all wafers will act the same when they are worn. While all wafers tend to swell a bit as they come in contact with fluids or output, the degree in which they swell can differ from brand to brand. Because of this, the patient may need to cut the wafer slightly larger to accommodate the expansion. Doing this also helps to prevent the wafer from “strangulating” the stoma by putting too much pressure around it.
Option C: Another thing about wafers is that they come in all kinds of sizes and materials. If the patient uses a wafer that doesn’t give enough space, he may end up having difficulties cutting it, or worse, develop leaks.
Option D: The patient should make sure that there’s about a 1/16 – 1/8? (approx. 1.5 – 3mm) gap between the stoma and the edge of the hole. Remember, as wafers do swell, he may need to adjust this gap accordingly.
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