A NURSING Journey with Special CHILD

A Journey with Special CHILDOSTOMY CARE EDUCATION FOR PARENT WHO HAVE A CHILD WITH STOMA... Here, we wont talk about stoma care, but well talk about a special child.... Yours...

Ok..weare ready to go homeI have a good news. Today, you can bring home your beautiful baby..Oh God, how can I do all those things...It seems complicated. I cant do that

Courtesy 1st ETNEP

Courtesy 1st ETNEP1001 questions of scary Moms about stoma care.What is stoma? What does stoma look like?Im afraid to touch it. Can it hurt him/ her?Can I do that? Its seems complicated.Can my baby take a bath?Can my baby sleep on their tummy?Can I breastfeed my baby?Can we travel?.....I cant afford to buy the supply. Do you have any suggestion for a cheaper one?Discharge Planning

Why is it important?When do you start it?What do you plan?Who is involved?How do you do that?

Do you concern about these?How to change the pouch?Breastfeed? What kind of food they could eat?Is it ok to take any medicine while my baby has a stoma?What if the baby gets diarrhea?Changing the pouch means...How to open/ close the pouch?How to peel off the pouch?What kind of solution do I suppose to use to clean the skin?How to measure the correct size?How to attach the pouch?What do I have to be concerned while doing this?How do you get the supply?...

Equipment ...

Cutter/ scissorPouch and clipper/ tailMeasurement toolSoft cotton clothSoft towelAny accessories if neededBaby cloths/ jumpsuitDisposal bag....

Here we go..

TipsInfant: Avoid to use agents that are alcohol based, adhesive remover, skin protective wipe6 month 2 yo: choose all-in-one jumpsuits/ vest for their cloth2 5 y.o: start to explain about their stoma, involve in aspect of care> 6 y.o: gaining independency of care

Make sure the parent knows about: The type of stoma The kind of product they need for their baby/ child, the type and size of the bag How will they get the supplyNutrition for a child with stoma

...special diet may be necessary due to other medical conditions, but not because of stoma... .......................................................... So, just follow the nature...Age-appropriate child feeding0-6 bulan6-121-2 tahun2-3 tahun3-5ASIBubur susuBubur nasiSayur dan lauk cacahBuah/ sari buah.Selingan antara 2 waktu makanNasi lembekSayur dan lauk lunakBuah/ sari buahBeri selingan antara 2 waktu makanNasiSayur, laukBuahSelingan antara 2 waktu makanSama dengan usia 2-3 tahunSumber: www.bidanindonesia.org, 2011Ostomate Food Refference ChartGas ProducingOdor ProducingIncreased StoolStoma ObstructiveAlkoholic bavCarbonated bavBeans/ SoyCabbageCauliflowerCucumberDairy productChewing gumMilkNutsOnions

AsparagusBaked beansBroccolliCabbageEggsFishGarlic OnionPeanut butterStrong cheeseAlcoholic bavWhole grainCooked cabbageFresh fruitGreens, leafyPruneRaw vegetableSpicesApple peelsCabbage rawCeleryCornDried fruitNutsOrangesPineapplePopcornSeedsOstomate Food Refference ChartColor ChangesOdor ControlConstipation ReliefDiarhea ControlAsparagusBeetsFood colourIron pillsRed jellyStrawberriesTomato saucesButtermilkCranberry juiceOrange juiceTomato juiceYogurtHot CoffeeCooked fruitCooked vegetabFresh fruitFruit juiceWaterWarm/hot bavApplesauceBananaBoiled ricePeanut butterTapiocaToastIleostomy ConcernSome foods such as seeds do not digest well and may not pass the ileostomy stoma.Make sure the child chews the food properly before swallowing.Drink plenty of fluidTIPS

New food can be added to the babys diet as recommendation gradually. Lactose intolerance is common thing. Eliminate it for several days and try again. If persistence, change to lactose free milkMedication in Stoma Care

Drugs having affect on stomal action

Treating ConstipationTreating DiarrheaLaxativeBulk-forming laxativeStimulant laxativeOsmotic laxativeFecal softenerAnti diarrheaAnti motility drugs

AntasidsCalcium channel blocker (e.g nefedipine)NSAIDDiureticIleostomy Absorption ConcernAltered transit time through the small intestineA large number of medication are prepared in the form of coated tablet or time releaseProvide uncoated tabletOr liquid form

.... Just inform the physician that your baby has a stoma when they write a prescription...

If the baby gets diarrheaMake sure the parent knows: what does the normal fecal look like?What does diarrhea, causes of diarrhea?Sign and symptom of dehydration?What do they have to do?

Causes of diarrheaDietMedicationDisease and or obstructionOther causes such as infection, mal absorptionsSign and symptom of dehydrationDecreased urine output Less active or unusual sleepy Has a dry mouthWhat does parent has to do?Oral fluid replacement (Keep on breastfeeding) Stop any new additional food*Call your doctor, ... soonHave you heard about ostomy support group?What is ostomy support group?Open to any individual who has experience ostomy surgeryHaving opportunity to interact with people who have lived with an ostomyAbility to discuss any issues they concernBe a self-help groupProviding support for people with ostomy such as advocates and lobbyists with government or appliance manufacture

... Do you have ostomy support group in your town ?Any Question??.... As I said, its not only about the stoma . Its about a special child.... Yours

We love you lots, Mom...RefferenceAhrendsen J. ( 2011). Advantages of Breastfeeding. Clarion. www.breastfeeding.comBlackley. (2004). Practical Stoma Wound and Continence Management. Victoria. Research Publications Pty. LtdBreckman. (2005). Stoma Care and Rehabilitation. Philadelphia. ElsevierBrewer. (2002). Diet and Nutrition Guide. United Ostomy Association, Inc.ConvaTec USA. (2011). Common Questions about Your Child Stoma. www.convatec.comHampton. (1992). Ostomies and Continent Diversions: Nursing Management. Missouri. Mosby Year Book, Inc.Holister. (2010). Caring for your Child with Ostomy. www.holister.comMilne et.al. (2003). Wound, Ostomy, and Continence Nursing Secrets. Philadelphia. Hanley & Belfus, Inc.(2011). www.bidanindonesia.org