A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of:
A. Increasing fluid intake to prevent dehydration.
B. Wearing an appliance pouch only at bedtime.
C. Consuming a low-protein, high-fiber diet.
D. Taking only enteric-coated medications.
Correct Answer: A. Increasing fluid intake to prevent dehydration.
Because stool forms in the large intestine, an ileostomy typically drain liquid waste. To avoid fluid loss through ileostomy drainage, the nurse should instruct the client to increase fluid intake. Monitor I&O. Note number, character, and amount of stools; estimate insensible fluid losses (diaphoresis). Measure urine specific gravity; observe for oliguria. Provides information about overall fluid balance, renal function, and bowel disease control, as well as guidelines for fluid replacement.
Option B: The nurse should teach the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Resume or advance diet as indicated (clear liquids progressing to bland, low residue; then high-protein, high-calorie, caffeine-free, non-spicy, and low-fiber as indicated).
Option C: The nurse should teach the client to avoid high-fiber foods because they may irritate the intestines. Avoid or limit foods that might cause or exacerbate abdominal cramping, flatulence (milk products, foods high in fiber or fat, alcohol, caffeinated beverages, chocolate, peppermint, tomatoes, orange juice).
Option D: The nurse should teach the client to avoid enteric-coated medications because the body can’t absorb them after an ileostomy. Allows the intestinal tract to readjust to the digestive process. Protein is necessary for tissue healing integrity. Low bulk decreases peristaltic response to meals.
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