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Question: Write a teaching plan,about colostomy care and education. Answer: The study is based on a case study of a 16-year-old girl who had an accident and suffered abdominal injuries. An emergency surgery left her with a temporary colostomy and doctors warned that she may end up with a permanent colostomy. She had other injuries too and suffered from frustration due to her condition. Although her family is by her side, still she does not want to look at her colostomy and is worried about her studies. She is estimated to have the colostomy for several years before reversal. The purpose of this study is to teach Sandra and family about how to care for colostomy. Diagnosis or planning From the data about the medical report of Sandra, the immediate need is to give her information about how to care for her colostomy herself, providing knowledge about the dietary requirement and offering emotional and psychological support to such patients. The goal-directed diagnosis includes- Adjusting patient to changes and managing colostomy. Minimizing complications Teaching self-care to handle situations Giving information about the procedure of ostomy appliance change, therapeutic regimen and informing family members about the importance of providing emotional support (Stelton et al., 2015). Implementation A colostomy is a surgical procedure by which an opening is created in the abdominal walls to take out one end of the intestine. There are many risks for a patient like bleeding inside abdomen, development of a hernia, infection in the lungs, skin irritation, wound breaking, etc. Therefore, it is necessary to teach Sandra and her family how to take care of the condition. The following are the guidelines for self-care of ostomy: Teachings principle of ostomy care: The appliances need to be changed regularly. Skin cleansing needs to be done, and stoma or opening should be inspected properly. It maintains skin integrity around the stoma. The pouch needs to be emptied before it is one-third full. Deodorants should be used to prevent odor from the stoma. In a case of complications, enterostomy therapy nurse should be immediately contacted. Their service is required both before and after surgery. Before surgery, the nurse helps patient with the placement of stoma, assists patients to determine the best place for stoma so that clothing does not disturb stoma output. After surgery, the nurse teaches patients and family member how to change ostomy appliance. It requires time and practice. So they assist in appliance change for first few times and then teach patients how to do it themselves. They can give advice on leaking and teaching techniques in case of any problem (Okamura et al., 2013). Patients can be given information about health services available for ostomy to assist patients in the initial phase after surgery. The biophysical element of disturbed body image includes the presence of stoma and loss of control over bowel movement. The psychosocial element includes altered body structure. In such case support should be given, and patients should be encouraged to verbalize feelings about colostomy. It will help patients to deal with the condition (Doenges et al., 2014). Teaching dietary requirement and fluid intake: The patient should take well-balanced diet and vitamin supplements to meet the deficiency in nutrients. They should be taught avoid foods that reduce gas and constipation. This is crucial for patients with the colostomy. They should be encouraged to take a significant amount of fluid to prevent dehydration (Gulanick Myers, 2013). Giving resource for emotional and psychological support: Close family member of a patient should be encouraged to give emotional support and motivation for recovery. They can be recommended to take help of counseling sessions in case of extreme depression due to disease. They should be informed about support groups to for peer support and knowledge about colostomy. The patient should be encouraged to interact with patients with the ostomy. Such person can be a good support and role model for patients. The patient should be explained the reason for surgery. It will help the client to deal with the ostomy to prevent long-term ostomy if it is temporary (Endall et al., 2014). Evaluation Evaluation of above implementation plan can be assessed by patients and family members motivation to learn. It is monitored whether patients perception and attitude towards the colostomy has changed or not after implementation plan. The measurement of self-care can be checked by assessing whether the patient can use stoma appliance herself or not. After the emotional support by way of counseling and family support, patients mental frame of mind can be assessed by taking feedbacks from the about the treatment process. In the end, an overall report can be documented orally or in written form explaining the benefits of diagnosis and implementation plan on patients (Danielsen et al., 2013). Reference Danielsen, A. K., Burcharth, J., Rosenberg, J. (2013). Patient education has a positive effect in patients with a stoma: a systematic review.Colorectal Disease,15(6), e276-e283. Doenges, M. E., Moorhouse, M. F., Murr, A. C. (2014).Nursing care plans: Guidelines for individualizing client care across the life span. FA Davis. Endall, G., Willis, H., Ugboma, D., Sampson, A., Bostock, K., Lewis, R. (2014). An integrated care pathway for peritoneal dialysis catheter insertion and post insertion management.BMC Public Health. Gulanick, M., Myers, J. L. (2013).Nursing care plans: nursing diagnosis and intervention. Elsevier Health Sciences. Okamura, K., Nojiri, Y., Tanaka, Y., Nagae, H., Arai, Y., Matsuda, T., ... Hasegawa, T. (2013). Changes in perioperative management of radical prostatectomy using clinical pathways according to a standardized care plan: A multi institutional study.International Journal of Urology,20(3), 337-343. Stelton, S., Zulkowski, K., Ayello, E. A. (2015). Practice Implications for Peristomal Skin Assessment and Care from the 2014 World Council of Enterostomal Therapists International Ostomy Guideline.Advances in skin wound care,28(6), 275-284.