You’re preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy. The patient tells you he’s anxious. What should your initial step be in working with this patient?
A. Determine what the patient already knows about colostomies.
B. Show the patient some pictures of colostomies.
C. Arrange for someone who has a colostomy to visit the patient.
D. Provide the patient with written material about colostomy care.
Correct Answer: A. Determine what the patient already knows about colostomies.
Initially, you should assess the patient’s knowledge about colostomies and how it will affect his lifestyle. Review anatomy, physiology, and implications of surgical intervention. Discuss future expectations, including anticipated changes in the character of effluent. Provides knowledge base from which the patient can make informed choices, and offers an opportunity to clarify misconceptions regarding an individual situation.
Option B: Include written, picture (photo, video, Internet) learning resources. This provides references for obtaining support, equipment, and additional information after discharge to support patient efforts for independence in self-care.
Option C: Ascertain whether support and counseling were initiated when the possibility and/or necessity of ostomy was first discussed. This provides information about the patient’s/SO’s level of knowledge and anxiety about an individual situation.
Option D: The patient may find it easier to accept or deal with an ostomy done to correct chronic or long-term disease than for traumatic injury, even if ostomy is only temporary. Also, patient who will be undergoing a second procedure (to convert ostomy to a continent or anal reservoir) may possibly encounter less severe self-image problems because body function eventually will be “more normal.”
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