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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Risk for Imbalanced Nutrition: Less Than Body Requirements

Nursing Diagnosis

  • Imbalanced Nutrition: Less Than Body Requirements

Risk factors may include

  • Prolonged anorexia/altered intake preoperatively
  • Hypermetabolic state (preoperative inflammatory disease; healing process)
  • Presence of diarrhea/altered absorption
  • Restriction of bulk and residue-containing foods

Possibly evidenced by

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  • Not applicable for risk diagnosis. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.

Desired Outcomes

  • Client will maintain weight/demonstrate progressive weight gain toward the goal with normalization of laboratory values and be free of signs of malnutrition.
  • Client will plan diet to meet nutritional needs/limit GI disturbances.
Nursing InterventionsRationale
Obtain a thorough nutritional assessment.Identifies deficiencies/needs to aid in the choice of interventions.
Auscultate bowel sounds.Return of intestinal function indicates readiness to resume oral intake.
Resume solid foods slowly.Reduces the incidence of abdominal cramps, nausea.
Identify odor-causing foods (e.g., cabbage, fish, beans) and temporarily restrict from the diet. Gradually reintroduce one food at a time.Sensitivity to certain foods is not uncommon following intestinal surgery. Patient can experiment with food several times before determining whether it is creating a problem.
Recommend patient increase use of yogurt, buttermilk, and acidophilus preparations.May help prevent gas and decrease odor formation.
Suggest patient with ileostomy limit prunes, dates, stewed apricots, strawberries, grapes, bananas, cabbage family, beans, and avoid foods high in cellulose, e.g., peanuts.These products increase ileal effluent. Digestion of cellulose requires colon bacteria that are no longer present.
Discuss the mechanics of swallowed air as a factor in the formation of flatus and some ways the patient can exercise control.Drinking through a straw, snoring, anxiety, smoking, ill-fitting dentures, and gulping down food increases the production of flatus. Too much flatus not only necessitates frequent emptying but also can cause leakage from too much pressure within the pouch.
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Recommended 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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