10 Ileostomy and Colostomy (Fecal Diversions) Nursing Care Plans

2012-06-17T04:48:00+08:00

Thank you for these nursing care plans! They’re great!

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2014-05-21T21:17:16+08:00

Readiness for enhanced learning (if they are willing to learn)

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2014-06-15T12:40:46+08:00

Thank you for this informative site!

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2019-03-13T13:04:49+08:00

Thank you for the Nursing process its very helpful.

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2021-08-29T15:06:06+08:00

This information is very helpful for us,,thank you so much for helping us

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2021-12-06T01:41:08+08:00

Thanks for these wonderful care plans.

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Nursing Interventions	Rationale
Evaluate the patient’s emotional, cognitive, and physical capabilities.	These factors affect the patient’s ability to master care-tasks and willingness to assume responsibility for ostomy care.
Include written, picture (photo, video, Internet) learning resources.	Provides references for obtaining support, equipment, and additional information after discharge to support patient efforts for independence in self-care.
Review anatomy, physiology, and implications of surgical intervention. Discuss future expectations, including anticipated changes in the character of effluent.	Provides knowledge base from which patient can make informed choices, and offers an opportunity to clarify misconceptions regarding an individual situation.
Instruct patient/SO in stomal care. Allot time for return demonstrations and provide positive feedback for efforts.	Promotes positive management and reduces the risk of improper ostomy care and development of complications.
Recommend increased fluid intake during warm weather months.	Loss of normal colon function of conserving water and electrolytes can lead to dehydration and constipation.
Discuss the possible need to decrease salt intake.	Salt can increase ileal output, potentiating the risk of dehydration and increasing frequency of ostomy care needs and/or patient’s inconvenience.
Identify symptoms of electrolyte depletion: anorexia, abdominal muscle cramps, feelings of faintness or “cold” in arms, legs, general fatigue, weakness, bloating, decreased sensations in arms or legs.	Loss of colon function altering fluid and electrolyte absorption may result in sodium or potassium deficits requiring dietary correction with foods and fluids high in sodium (bouillon, Gatorade) or potassium (orange juice, prunes, tomatoes, bananas, Gatorade).
Discuss the need for periodic evaluation and administration of supplemental vitamins and minerals as appropriate.	Depending on portion and amount of bowel resected, lack of absorption may cause deficiencies.
Stress importance of chewing food well, adequate intake of fluids with or following meals, only moderate use of high-fiber foods, avoidance of cellulose.	Reduces the risk of bowel obstruction, especially in a patient with ileostomy.
Review foods that may be a source of flatus. For example: carbonated drinks, beans, beer, cabbages, onions, fish and highly seasoned food.	These foods may be restricted or eliminated, based on individual reaction, for better ostomy control, or it may be necessary to empty the pouch more frequently if they are ingested.
Identify foods associated with diarrhea, such as green beans, broccoli, highly seasoned foods.	Promotes more even effluent and better control of evacuations.
Recommend foods used to manage constipation (bran, celery, raw fruits), and discuss the importance of increased fluid intake.	Proper management can prevent or minimize problems of constipation.
Discuss the resumption of the presurgery level of activity. Suggest emptying the ostomy appliance before leaving home and carrying a fanny pack with fresh supplies. Recommend resources for obtaining attractive appliances and decorative cummerbunds as appropriate.	With a little planning, patient should be able to manage the same degree of activity as previously enjoyed and in some cases increase activity level. A cummerbund can provide both physical and psychological support when the patient is involved in activities such as tennis and swimming.
Talk about the possibility of sleep disturbance, anorexia, loss of interest in usual activities.	“Homecoming depression” may occur, lasting for months after surgery, requiring patience and support and ongoing evaluation as the patient adjusts to living with a stoma.
Explain the necessity of notifying healthcare providers and pharmacists of type of ostomy and avoidance of sustained-release medications.	Presence of ostomy may alter the rate and extent of absorption of oral medications and increase the risk of drug-related complications, e.g., diarrhea or constipation or peristomal excoriation. Liquid, chewable, or injectable forms of medication are preferred for patients with an ileostomy to maximize absorption of the drug.
Counsel patient concerning medication use and problems associated with altered bowel function. Refer to pharmacist for teaching and/or advice as appropriate.	Patient with an ostomy has two key problems: altered disintegration and absorption of oral drugs and unusual or pronounced adverse effects. Some of the medications that these patients may respond to differently include laxatives, salicylates, H₂receptor antagonists, antibiotics, and diuretics.
Discuss the effect of medications on effluent, i.e., changes in color, odor, consistency of stool, and need to observe for drug residue indicating incomplete absorption	Understanding decreases anxiety regarding intestinal function and enhances independence in self-care.
Stress necessity of close monitoring of chronic health conditions requiring routine oral medications.	Monitoring of clinical symptoms and serum blood levels is indicated because of altered drug absorption requiring periodic dosage adjustments.

10 Ileostomy and Colostomy Nursing Care Plans

Nursing Care Plans

10. Deficient Knowledge

Deficient Knowledge

10. Deficient Knowledge

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