The nurse instructs the ileostomy client to do which of the following as a part of essential care of the stoma?
A. Cleanse the peristomal skin meticulously.
B. Take in high-fiber foods such as nuts.
C. Massage the area below the stoma.
D. Limit fluid intake to prevent diarrhea.
Correct Answer: A. Cleanse the peristomal skin meticulously.
The peristomal skin must receive meticulous cleansing because the ileostomy drainage has more enzymes and is more caustic to the skin than colostomy drainage. Dry the skin completely before putting on the skin barrier or pouch. Watch for sensitivities and allergies to the adhesive, skin barrier, paste, tape, or pouch material. They can develop after weeks, months, or even years of using a product because the client can become sensitized over time.
Option B: Foods such as nuts and those with seeds will pass through the ileostomy. The client should be taught that these foods will remain undigested. Many factors, such as foods, normal bacteria in your intestine, illness, certain medicines, and vitamins can cause odor.
Option C: The area below the ileostomy may be massaged if needed if the ileostomy becomes blocked by high fiber foods. There will be times when an ostomy does not have an output for short periods of time. This is normal. But, if the stoma is not active for 4 to 6 hours and the client has cramps, pain, and/or nausea, the intestine could be blocked (the medical word is obstructed).
Option D: Fluid intake should be maintained to at least six to eight glasses of water per day to prevent dehydration. Drinks such as Gatorade®, PowerAde®, or Pedialyte® contain potassium and sodium. But any liquid containing water (soda, milk, juice, tea, etc.) helps to meet the daily need for fluid.
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