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Nov 24

IRIGASI KOLOSTOMI


Irigasi stoma adalah suatu cara untuk mengeluarkan isi kolon ( feses ), dilakukan secara terjadual dengan memasukkan sejumlah air dengan suhu yang sama dengan tubuh / hangat.
Tujuan tindakan ini adalah merangsang kontraksi usus sehingga mendorong keluarnya isi kolon ( feses ). Tindakan ini dapat dilakukan pada saat luka operasi sudah benar-benar sembuh, dan tidak ada lagi rencana tindakan lanjutan seperti, kemoterapi / radiasi, atau dapat dilakukan setalah 3 bulan setelah selesai radiasi / kemoterapi. Manfaat tindakan ini adalah feses akan keluar secara teratur / terjadwal, mengurangi pembentukan gas, meminimalkan komplikasi di stoma, mencegah konstipasi, mengurangi penggunaan kantong dan meningkatkan rasa percaya diri.

Indikasi

Irigasi kolostomi dapat dilakukan pada pasien dengan kolostomi desenden / sigmoid, karena feses mereka sudah terbentuk, pasien dengan riwayat bab regular, pasien yang mampu melakukan prosedur irigasi

Kontraindikasi

Irigasi kolostomi tidak dapat dilakukan pada pasien dengan riwayat iritable bowel syndrom, stoma pada kolon asenden dan tranversum, stoma prolaps dan hernia peristoma, pasien dengan kemoterapi, radiasi pelvis, pasien dengan diagnosis yang buruk / diare, dan pasien dengan urostomi dan ileustomi

Waktu irigasi kolostomi

1. Paling efektif dilakukan 1 jam setelah makan, karena kolon sudah terisi penuh

2. Dilakukan 1 x sehari atau lebih tergantung dari keteraturan usus

3. Harus dilakukan secara rutin dan pada waktu yang sama

4. Waktu yang digunakan selama irigasi sekitar 30 – 90 menit

5. Kira-kira 6-8 minggu diharapkan pola eliminasi menjadi teratur

Alat-alat yang digunakan

  1. Kantung irigasi
  2. Plastik irigasi
  3. Pengontrol aliran air
  4. Cone – tip
  5. Air irigasi ( air matang hangat )
  6. Kantung stoma yang bersih
  7. Jelly, tali untuk mengikat, klip

Prosedur Pelaksanaan Irigasi Kolostomi

1.Cuci tangan, jelaskan kembali prosedur jika diperlukan.

2. Dekatkan alat-alat yang dibutuhkan ( di kamar mandi ).

3. Jaga privasi.

4. Pasien dalam posisi duduk di kloset.

5. Isi kantong irigasi dengan air yang tersedia ( air hangat / air khusus untuk irigasi)

dan gantung pada tempat yg tinggi ( tiang infus / dinding ).

6. Alirkan air kedalam selang, hindari adanya udara dalam selang.

7. Siap untuk memulai irigasi kolostomi.

8. Lepaskan kantung stoma lalu pasang plastik irigasi dan masukkan ujung selang

kedalam stoma.

9. Letakkan plastik irigasi ke dalam kloset untuk memfasilitasi pengeluaran ke

dalam kloset.

10. Hubungkan cone-tip cateter dengan kateter dan beri jelly.

11. Masukkan cone-tip ke dalam stoma dan tangan tetap memegang cone-tip untuk

menahan..

12. Alirkan air dengan aliran yang cukup ( 10 – 15 menit ), lambatkan aliran jika

terdapat tanda-tanda kram abdomen.

13. Klem kateter dan tutup stoma 15 – 20 menit

14. Satu jam kemudian pengeluaran akan terjadi, biarkan sampai semua feses

keluar.

15. Bersihkan area stoma dengan sabun lembut dan air.

16. Pasang kembali kantung stoma.

17. Catat tindakan yang dilakukan dan perhatikan warna dan kondisi stoma dan kulit

peristoma, catat warna, konsistensi dan jumlah feses yang keluar.

18. Cuci tangan dan rapihkan alat.

Komplikasi

Komplikasi

Penyebab

Manajemen

Kram abdomen · Air terlalu dingin

· Aliran terlalu cepat

· Tube berisi udara

Kurangikecepatan aliran

Anjurkan nafas dalam selama kram hilang

Respon Vasovagal Stimulus yang berlebihan pada nervus vagal Hentikan irigasi, cek tekanan darah
Cairan tidak kembali keluar Dehidrasi Tambahkan air hingga 2.000cc

Edukasi untuk minum banyak

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