The nurse teaches the client with a urinary diversion to attach the appliance to a standard urine collection bag at night. The most important reason for doing this is to prevent:
A. Urine reflux into the stoma.
B. Appliance separation
C. Urine leakage
D. The need to restrict fluids.
Correct Answer: A. Urine reflux into the stoma.
The most important reason for attaching the appliance to a standard urine collection bag at night is to prevent reflux into the stoma and ureters, which can result in infection. Unlike the Indiana pouch, the ileal conduit is not continent because of its small size. Urine is not collected and held in the pouch but continuously flows out of the stoma. An ileal conduit requires you to wear an external urostomy bag that adheres to the skin around the stoma and collects urine.
Option B: The use of a standard collection bag also keeps the appliance from separating from the skin. Closely monitor the stoma’s color, size, discharge, and the skin around it. Know what is normal and what is not. The client should’ve been thoroughly educated by the ostomy nurse.
Option C: The use of a standard collection bag helps prevent urine leakage from an overly full bag, but the primary purpose is to prevent reflux of urine. Washing around the stoma with water is enough, but the client can use mild unscented soap if he wants. If he is wearing a pouch, rinse well because soap can affect the adhesiveness of the skin barrier.
Option D: A client with a urinary diversion should drink 2000-3000 ml of fluid each day; it would be inappropriate to suggest decreasing fluid intake. Cleaning the stoma and skin with water is enough. If the client wishes to use soap, rinse well as soap might affect the adhesiveness of the skin barrier. Pat the skin dry before putting on the skin barrier and pouch.
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