The nurse teaches the client with an ileal conduit measure to prevent a UTI. Which of the following measures would be most effective?
A. Avoid people with respiratory tract infections.
B. Maintain a daily fluid intake of 2,000 to 3,000 ml.
C. Use sterile technique to change the appliance.
D. Irrigate the stoma daily.
Correct Answer: B. Maintain a daily fluid intake of 2,000 to 3,000 ml.
Maintaining a fluid intake of 2,000 to 3,000 ml/day is likely to be effective in preventing UTI. A high fluid intake results in high urine output, which prevents urinary stasis and bacterial growth. Infections can occur when urine is not drained frequently or completely. They can also occur when the catheter is contaminated by the user’s hands. Watch out for foul-smelling, cloudy, or dark urine as this is a common symptom.
Option A: Avoiding people with respiratory tract infections will not prevent urinary tract infections. Change the pouching system once a week or more to avoid leaks and skin irritation. If there is itching and burning around the stoma, it is a sign for the client to change the pouching system and clean the skin.
Option C: Clean, not sterile, technique is used to change the appliance. 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.
Option D: An ileal conduit stoma is not irrigated. Be gentle when removing the pouch system. Do not rip the skin carrier off but peel it away gently. Don’t remove the pouching system more than once a day unless there is an issue.
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