A nurse is reinforcing discharge teaching with a client on how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching?
A.
Change the ostomy pouch daily.
B.
Empty the ostomy pouch when it is 2/3 full.
C.
Trim the opening of the ostomy seal to be 1/2 inch wider than the stoma.
D.
Apply lotion to the peristomal skin when changing the ostomy pouch.
The correct answer and Explanation is :
The correct answer is B. Empty the ostomy pouch when it is 2/3 full.
Explanation:
When caring for a newly created ileal conduit, it’s crucial to follow proper ostomy care guidelines to ensure the comfort and health of the client. Here’s a breakdown of why option B is the best practice:
- Empty the Ostomy Pouch When It Is 2/3 Full:
- Rationale: It is recommended to empty the ostomy pouch when it is about 1/3 to 2/3 full. This practice helps prevent the pouch from becoming too heavy, which can lead to leakage and skin irritation around the stoma. Overfilling the pouch can also cause discomfort and increase the risk of the pouch detaching from the skin barrier. Regular emptying ensures that the system remains secure and comfortable.
- Change the Ostomy Pouch Daily (Option A):
- Rationale: Daily pouch changes are not typically necessary for all patients. The frequency of pouch changes depends on the type of ostomy pouch used, the amount of output, and the individual’s skin condition. Most people with ileal conduits change their pouches every 3-7 days. Overchanging can lead to skin irritation and is generally not recommended unless there are specific concerns like leakage or skin issues.
- Trim the Opening of the Ostomy Seal to Be 1/2 Inch Wider Than the Stoma (Option C):
- Rationale: The opening of the ostomy seal should be cut to fit snugly around the stoma without applying too much pressure. Typically, it is advised to cut the seal so that it is just slightly larger than the stoma, often about 1/8 inch wider, to avoid any constriction or irritation. A 1/2 inch wider opening is generally excessive and could compromise the seal’s effectiveness.
- Apply Lotion to the Peristomal Skin When Changing the Ostomy Pouch (Option D):
- Rationale: It is not recommended to apply lotion or creams to the peristomal skin when changing the ostomy pouch. These products can interfere with the adhesive properties of the ostomy pouch and seal, potentially leading to leaks and skin issues. The peristomal skin should be kept clean and dry before applying a new pouch.
In summary, proper care for an ileal conduit involves managing the ostomy pouch to prevent overfilling, ensuring a good fit around the stoma, and avoiding substances that might interfere with the adhesive seal.