10 Ileostomy and Colostomy Nursing Care Plans

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An ileostomy is an opening constructed in the terminal ileum to treat regional and ulcerative colitis and to divert intestinal contents in colon cancer, polyps, and trauma. It is usually done when the entire colon, rectum, and anus must be removed, in which case the ileostomy is permanent. A temporary ileostomy is done to provide complete bowel rest in conditions such as chronic colitis and in some trauma cases.

colostomy is a diversion of the effluent of the colon and may be temporary or permanent. Ascending, transverse, and sigmoid colostomies may be performed. Transverse colostomy is usually temporary. A sigmoid colostomy is the most common permanent stoma, usually performed for cancer treatment.

Nursing Care Plans

Nursing care management and planning for patients with ileostomy or colostomy includes: assisting the patient and/or SO during the adjustment, preventing complications, support independence in self-care, provide information about procedure/prognosis, treatment needs, and potential complications.

Here are 10 nursing care plans (NCP) and nursing diagnosis for patients with fecal diversions: colostomy and ileostomy:

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  1. Risk for Impaired Skin Integrity
  2. Disturbed Body Image
  3. Acute Pain
  4. Impaired Skin Integrity
  5. Deficient Fluid Volume
  6. Risk for Imbalanced Nutrition: Less Than Body Requirements
  7. Risk for Sexual Dysfunction
  8. Disturbed Sleep Pattern
  9. Risk for Constipation or Diarrhea
  10. Deficient Knowledge
  11. Other Nursing Care Plans
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Acute Pain

Nursing Diagnosis

May be related to

  • Physical factors: e.g., disruption of skin/tissues (incisions/drains)
  • Biological: activity of disease process (cancer, trauma)
  • Psychological factors: e.g., fear, anxiety

Possibly evidenced by

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  • Reports of pain, self-focusing
  • Guarding/distraction behaviors, restlessness
  • Autonomic responses, e.g., changes in vital signs

Desired Outcomes

  • Client will verbalize that pain is relieved/controlled.
  • Client will display relief of pain, able to sleep/rest appropriately
  • Client will demonstrate the use of relaxation skills and general comfort measures as indicated for an individual situation.
Nursing InterventionsRationale
Assess pain, noting location, characteristics, intensity (0–10 scale).Helps evaluate the degree of discomfort and effectiveness of analgesia or may reveal developing complications. Because abdominal pain usually subsides gradually by the third or fourth postoperative day, continued or increasing pain may reflect delayed healing or peristomal skin irritation. Note: Pain in the anal area associated with abdominal-perineal resection may persist for months.
Encourage patient to verbalize concerns. Active-listen these concerns, and provide support by acceptance, remaining with the patient, and giving appropriate information.Reduction of anxiety/fear can promote relaxation or comfort.
Provide comfort measures, e.g., mouth care, back rub, repositioning (use proper support measures as needed). Assure patient that position change will not injure stoma.Prevents drying of oral mucosa and associated discomfort. Reduces muscle tension, promotes relaxation, and may enhance coping abilities.
Encourage use of relaxation techniques, e.g., guided imagery, visualization. Provide diversional activities.Helps patient rest more effectively and refocuses attention, thereby reducing pain and discomfort.
Assist with ROM exercises and encourage early ambulation. Avoid prolonged sitting position.Reduces muscle/joint stiffness. Ambulation returns organs to normal position and promotes the return of usual level of functioning. Note: Presence of edema, packing, and drains (if perineal resection has been done) increases discomfort and creates a sense of needing to defecate. Ambulation and frequent position changes reduce perineal pressure.
Investigate and report abdominal muscle rigidity, involuntary guarding, and rebound tenderness.Suggestive of peritoneal inflammation, which requires prompt medical intervention.
Administer medication as indicated, e.g., narcotics, analgesics, patient-controlled analgesia (PCA).Relieves pain, enhances comfort, and promotes rest. PCA may be more beneficial, especially following anal-perineal repair.
Provide sitz baths.Relieves local discomfort, reduces edema, and promotes healing of perineal wound.
Apply/monitor the effects of transcutaneous electrical nerve stimulator (TENS) unit.Cutaneous stimulation may be used to block transmission of the pain stimulus.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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