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:

  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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Impaired Skin Integrity

Nursing Diagnosis

  • Impaired Skin Integrity

May be related to

  • Invasion of body structure (e.g., perineal resection)
  • Stasis of secretions/drainage
  • Altered circulation, edema; malnutrition

Possibly evidenced by

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  • Disruption of skin/tissue: presence of incision and sutures, drains

Desired Outcomes

  • Client will achieve timely wound healing free of signs of infection.
Nursing InterventionsRationale
Observe wounds, note characteristics of drainage.Postoperative hemorrhage is most likely to occur during the first 48 hr, whereas infection may develop at any time. Depending on the type of wound closure (e.g., first or second intention), complete healing may take 6-8 mo.
Change dressings as needed using aseptic techniqueLarge amounts of serous drainage require that dressings be changed frequently to reduce skin irritation and potential for infection.
Encourage side-lying position with the head elevated. Avoid prolonged sitting.Promotes drainage from perineal wound/drains, reducing the risk of pooling. Prolonged sitting increases perineal pressure, reducing circulation to wound, and may delay healing.
Irrigate wound as indicated, using normal saline (NS), diluted hydrogen peroxide, or antibiotic solution.May be required to treat preoperative inflammation and/or infection or intraoperative contamination.
Provide sitz baths.Promotes cleanliness and facilitates healing, especially after packing is removed (usually day 3–5).
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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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