We must remember that life with a stoma – is not a disease. But the operated people in the first year after surgery as a young child must learn to live with a stoma, adapt to it. And it’s not just a problem for ostomy care, but also psycho­adaptation logic.

In most cases, patients with a stoma WHO­rotate to a normal life and go to work that was performed prior to surgery. However, to engage in heavy lifting, digging or heavy manual labor is not recommended. If ahis work involves heavy physical LOAD­Kami, it may be necessary to change it.

A person with a stoma can travel with the following items necessary items for the care of one hundred­and my colostomy bags.

With careful planning, training and ReA­bilitatsii people with a stoma can be engaged in de­Lamy that I did before the operation.

The patient is not contraindicated: swimming in the water­emah, exercise – limiting, of course, the load on the abdominal muscles. Colostomy is not an obstacle to the sexual life of the patient, polo­Wai potency when it is not reduced. possible on­Rushen, wearing a purely psychogenic. There are many instances when young patients have a family and children. Man is not dollars­wives “to go into the disease”, avoid everything that makes life a varied and interesting.

Сare of the patient with a gastrostomy

When obstruction of the esophagus associated with not­resectable tumor is superimposed on the stomach fistula, gastrostomy, which is introduced through pipe­ke made patient nutrition. Much less, if you can not supply through the stomach, similar to the fistula-eyunostoma superimposed on the jejunum. In both cases, the hollow body (the­ludok, jejunum), hemmed on the front bryush­hydrochloric wall rubber tube is introduced, so that­It is attached to the anterior abdominal wall suture or adhesive tape strips a length of 15 – 16 cm Tube.­ka introduced near laparotomic wounds sewn up tight.

The patient is administered high calorie easily assimilated food semiliquid consistency. Often­she feeds – 4 – used once a day. after eachFeeding should be carried out in the toilet area of ​​the stoma.

Relatives should participate in the core­straightening of the patient through a gastrostomy, since this process requires a lot of patience and tact in connection

the fact that quite often patients suffer from lack of appetite, aversion to food. should teach­Tyva tastes of the patient, his preference for this or that dish. Throughout the procedure, feed­Nia food should be warm and look APME­titno not to deprive the patient of taste Feeling­Nij. For wet food and saliva secretion of digestive glands excitation patient before­Laga chew food and then depositing­Vat its mouth (spitting) to the funnel, from wheretogether with the liquid mixture is injected through the tube into the stomach food.

For feeding the patient should:

• prepare: a glass of water, the capacity for pro­myvnyh water glass or plastic crows­Ku, sterile pack of napkins clamp polyethylene­new bag to dump waste fats­fetok, liquid and solid food consistency
• remove the rubber tube napkin close­and a conductive input terminal, reset a garbage bag;
• inserted into the end of the rubber tube a glass or plastic funnel;
• pick up the funnel, slightly bent in a hundred­Ron patient;
• give the patient a plate of food for chewing;
• offer the patient shift (spit) chewed food from the mouth into the funnel;
• pour chewed food warm liquid pi­schevoy mixture;
• Rinse the funnel and a rubber tube after core­straightening warm tea, rose hips extract (to avoid putrefaction of food residues in the rubber tube);
• remove the funnel;
• imposed on the end of the rubber tube is sterile­hydrochloric napkin and pinch clip;
• fix clamp loop length of bandage, wound up the patient’s neck;
• give the patient a glass of water and put a number capacity for washing water;
• help the patient to rinse the mouth of the food;
• clean washing water tank;
• give the patient chewing gum (for pre-­warnings related stomatitis formation in the oral cavity).

Note: remove the plastic trash bag. Wash and boil funnel dvuhpro­percentage soda solution for 15 minutes with a mo­ment boiling. Dry the funnel and put on the bedside table, covered with a cloth.

The skin around the stoma treatment is carried out on a daily basis, since the gastric juice, falling on the skin, causing irritation.

Actions in this should be the following:

• prepare 0.5-percent solution of chlorhexidine bigluconate or 0.5 percent solution of potassium permanganate, scissors, a spatula, a paste or Lassara zinc ointment, an adhesive plaster, a package with a sterile dressing, polyethylene­new bag, a container with warm water;
• explore the strip adhesive tape, which is wrapped and attached to the patient’s skin glands,­A new tube;

Note: otkleevanii with adhesive tape must be replaced: preparing strip adhesive tape length of at least 15 – 16 cm rubber tube is folded and fixed to the skin of the patient.

• put a bottle of ointment in a container of warm water;
• wash your hands twice with soap and treat them with alcohol;
• to treat the skin around the stoma tissue, SMOchennoy 0.5 percent solution of potassium permanganate (blotting movements;
• throw in the towel made of polyethylen­Lenovo bag;
• dry skin around stoma dry sterile cloth;
• throw the tissue in a plastic bag;
• cause spatula sufficiently thick layer (at least 0.5 cm) heated paste Lassara or zinc ointment sterile towel, cut type “pants” (first napkin is placed down cut, the second – the cut up, the third – on the left, the fourth – right);
• fold gauze in four layers;
• make it a cut in the center;
• Lay napkin with a large opening on the top of sterile napkins and output the rubber tube through a hole in a napkin;
• glue strips of plaster cloth big four sides.

Note:

1. After feeding through a gastrostomy leave the patient in the “reclined” position for 30 minutes.
2. When caring for a patient having a gastrostomy tube should be positioned so patsientav bed, so he was not lying on the probe.
3. Through feeding a patient through the gastrostomy and watching her in the intervals between the armature­straightening, make sure that the probe is well fixed in the stoma and the content does not appear either
   through the stoma, or through a tube.

In case of violation of the natural flow of urine associated with a tumor of the prostate, it is the high section of the bladder. In epitsistoma can be created during this operation (view urostomy) – suprapubic urocystic fistula (up responses­stie in the bladder to drain urine).

If epitsistoma left for extended periods or permanently, urine drainage is carried out through the catheter capitate Petstsera Malek, who at sformi­Rowan fistula do not require fixing. replace kata­tera produces a doctor at least once a month, as there may be blockage of the urinary catheter salts.

The distal end of the catheter through the tube conn­nyaetsya a urinal. If the patient walks,drainage bag attached to his legs, or troubles­ru, if the patient is lying in bed, the bag is suspended from the frame of the bed.

Patients with long-term epitsistomoy can locat­be under outpatient observation.

With sufficient bladder capacity Paci­UNT is in the daytime do not containe­Conner urine collection, and closing the outer end of emptying the bladder, as usual, with The appearance­lenii urge to urinate.

If the condition and age of the patient to allow the deal with the case familiar to him, for it­nd there are no contraindications. To by Paci­Enta no unpleasant smell of urine is required­mo more frequent hygienic measures in the genital area and epitsistomy. Processing Epicyte stoma-the same as the processing gastrostomy (see. “Processing gastrostomy”).

The use of the urinal with urine incontinence in men

Incontinence patient applied the bag, which helps keep the patient clean underwear and does not exude unpleasant odors.

To do this:

• prepare: urinal, urine container, the connecting tube, gloves, wipes, antiseptic solution, oil cloth, most napkin;
• ask the patient to lift the bowl and lay it under the buttocks and napkin oilcloth;
• ask the patient to bend your knees slightly and push them;
• wash hands and treat them twice with 70-gras­dusnym alcoholic solution;
• between the patient’s thighs to put the container with warm water and soap;
• and move the foreskin to expose the glans penis;
• the treated area of ​​the outer opening urine­emissivity channel;
• dry with a dry cloth;
• open the packaging with a urinal (it Napo­Mina on the form and type of condom);
• grab the penis with his left hand;
• take right hand over the bag zhestkuyuchast;
• lift the penis and put on his head the bag;
• Roll out the bag to the base of the penis;
• secure the bag at the base of the penis special adhesive tape;
• inserted into the bag the connecting pipes­ku; attach the bag to a container to collect the urine.
• fix the container on the bed (if PA­cient does not go as well as at night) or on the patient’s thigh during the day, if he goes;
• remove the container with water, oil cloth, napkins by­Place in a plastic bag;
• wash your hands twofold.

Note: a container for collecting urine q.s.­Dimo rinse thoroughly and pour onto bottom few crystals of potassium permanganate to prevent malodor.

Patients recovering from surgery can improve your immunity by using the people advice­Noah medicine.

onerecipe.

Take 300 grams of dried apricots; 300 grams of raisins; 3 with lemon peel.

Mince and add 1 table­honey-hand.

Take: on the first spoonful – adults at first a teaspoon – children, 1 times a day, preferably in the morning on an empty stomach or before dinner, one hour before meals. It can be taken at night.

2recipe.

Mark: 100 grams of treated ground nuts; 100 grams of pureed peeled apples; 2 limo­on (juice); 1 tablespoon honey.

The whole mass of mix. Accept composition according to the first tablespoon (1st teaspoon) 2 – 3 times a day before meals.

3recipe.

Lemon grind with garlic (1 lemon zest 1 head and garlic). Can all be chopped. Behind-

casting the cooked weight of 0.5 liters of boiled water cooled. Close the container with the prepared mixture and place in refrigerator for 3 – 5 days.

Take the first spoonful in the morning on the­empty stomach. Taken continuously until you come on­are positive changes in the body.

All the mixtures should be stored in the refrigerator.

During radiation and chemotherapy Paci­ENTOV decreased blood hemoglobin. To increase the hemoglobin level is recommended for­ratit attention to well-known plant – edge­beer burning, or rather, on the juice of this plant. Kra­Beer has unique medicinal their­properties. Fresh nettle juice squeezed from May to September. Fresh nettle shoots are cut and about­passed through a meat grinder or a juicer.

Take: for the first 1/2 teaspoon in a glass of water 20 minutes before eating.

nettle juice is good mixed with birch – except in­Denia 1: 5, in a mixture with carrot – a dilution of 1: 2.

When receiving the juice not only increases blood hemoglobin, but in general strengthens the body by enhancing immunity. folk Celite­Whether called nettle vitamin piggy bank. It contains vitamins C, A, K, B2, E. Moreover, vita­With the mine in the leaves of the nettle twice more than in the berries of black currant, and vitamin A, no less than in carrots and sea buckthorn fruits. A lot of it, and the green pigment chlorophyll, protein. The nettle contains a significant set of mic­element deficiencies of iron, nickel, copper, promoting

formation of red blood cells and improve gemoglo­Bina.

Attention! We should not get involved in regular cooking nettle people suffer­conductive hypertension, since nettle accelerates blood clotting and may contribute to thrombosis.

Palliative care begins when all other treatments are no longer effectiveness­tive, when a person starts talking about Smer­minute, when they begin to deny the vital organs. The aim of this treatment is to create opportunities for the patient a better quality zhiz­no. It should be aimed not only satisfies­letvorenie physical needs of the patient, but also to meet the equally important – Psychologists­iCal, social and spiritual.

In the palliative treatment of primary purpose is not to prolong life and make the rest as comfortable and meaningful as possible.

Palliative treatment will be effective:

• if it is possible to create and maintain for PA­patient’s comfort and safety conditions;
• if the patient will feel the most their independence;
• if the patient does not feel pain;
• If, despite the impending loss of life, providing patient support system for­he may live as actively and creatively as much as possible for him.

Relatives should actively participate in the palliative treatment of their loved ones. In order to provide support to the patient, should give him the opportunity to express their feelings, even if it will be feelings of anger, grief. Not to let the manifestation of negative emotions. Tact, resists­ka, attention, sensitivity to help families in dealing with the patient.

Communicating with the patient, try to set aside time for him to see that you do not rush­Tes. You should always keep in mind that if your near­cue the person is terminally ill, he sometimes does not feel fear and despair, until he sees the fear and despair in the eyes of others. About the diagnosis of PA­cient can guess by your eyes, Mimi­ke, gestures, ie body language. You should not pretend to be cheerful, to lie, to avoid direct and honest conversation. False optimism is the destroyer of hope. It is absolutely not taken into account, that the orientation only on the positive­tion in life brings a person relaxes and cheating, making it unstable in the mountain. He can not cope with the dropped its share of misfortune­eat.

The patient can follow the most insignificant­GOVERNMENTAL changes and interpret them as if­signs of improvement or deterioration of their consisting­Nia. In any case, knowing that he was doomed, trail­a fight for the quality of life, not its duration. It should agree with that­Kimi patient decisions as refusal to eat, and by visitors, or vice versa – the desire to see them. It is necessary to continue the basic nursing care, aiming to perform gigieniches­FIR procedures to ensure the purity of the skin and

prevention of pressure ulcers. It is recommended to apply and relaxing treatments such as deep breathing, rubbing and massage, to­extremities.

Currently, the organization created, obe­Dinh efforts of medical staff, the priesthood­nicks and psychologists to assist the hopeless­nym patients.