1. The client/caregiver can define ileostomy.
    1. An ileostomy is a surgical opening between the ileum and the abdominal wall.
    2. A small portion of the intestine is sewed to the surface of the abdomen to create a “stoma.”
    3. The purpose of an ileostomy is to bypass a diseased colon and rid the body of wastes.
  2. The client/caregiver can describe the basic anatomy and physiology of the small intestine.
    1. The small intestine is approximately 18 feet long and is divided into three sections.
    2. The ileum is the last section of the small intestine and is connected to the large intestine at the ileocecal valve.
    3. Digestive enzymes are secreted and fluid is absorbed in the small intestine.
  3. The client/caregiver can demonstrate emptying a pouch.
    1. Empty when one-third full.
    2. Sit on the toilet or place on a chair with the pouch opening placed in the toilet.
    3. Put toilet paper on the surface of the toilet water to avoid splashing.
    4. Remove clamp and let contents empty into the toilet.
    5. Squeeze the remaining contents out of the pouch.
    6. While holding up the end of the pouch, pour a cup of water into the pouch, swish, and empty. Do not get the stoma or adhesive seal wet.
    7. Use toilet paper to clean around the opening of the pouch and clamp the pouch shut.
  4. The client/caregiver can demonstrate the procedure of changing the pouching system.
    1. Change pouch every 5 to 7 days or as needed.
    2. Assemble all of the equipment.
    3. Hold skin taut, and peel off the pouch being worn.
    4. Wash the skin thoroughly with soap and water, rinse, and pat dry.
    5. Inspect the stoma for any change in size or color.
    6. Inspect the skin for signs of irritation and apply a skin barrier.
    7. Apply pouch over the stoma, being sure that it is the appropriate size and fits closely around the stoma.
  5. The client/caretaker can list dietary measures for the management of ileostomy.
    1. Chew food slowly and completely for better digestion.
    2. Drink at least six to eight glasses of fluids per day.
    3. Avoid foods that may cause blockage such as celery, corn, lettuce, popcorn, nuts, coleslaw, and seeds.
    4. Decrease fiber in the diet if stools are excessively loose.
    5. Limit or avoid foods such as eggs, fish, onions, and cabbage, which can increase odor.
    6. Eat foods such as spinach, parsley, yogurt, or buttermilk, which can decrease odor.
  6. The client/caregiver can list general measures for the management of an ileostomy.
    1. Avoid laxatives, enteric-coated pills, and timed-release pills.
    2. Avoid stress and smoking.
    3. Assess for skin irritation caused by enzymes in stools, and provide skin care.
    4. Avoid contact sports and weight lifting.
    5. Avoid tight, constrictive clothing.
    6. Keep extra ileostomy supplies on hand.
    7. Wear a Medic Alert bracelet.
    8. Report to the physician any signs of bleeding, persistent diarrhea, change in size or color of stoma, and continued skin irritation.
  7. The client/caregiver is aware of possible complications.
    1. Dehydration
    2. Bowel obstruction
    3. Electrolyte imbalance

Resources

United Ostomy Associations of America, Inc.www.uoaa.org
Wound, Ostomy, Continence Nurseswww.wocn.org

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Inc.Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott

Credits

Client Teaching Guides for Home Health Care, 2nd ed.© 2008 Jones and Bartlett Publishers, Inc.www.jbpub.com

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