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 Sexual Dysfunction

Nursing Diagnosis

Risk factors may include

  • Altered body structure/function; radical resection/treatment procedures
  • Vulnerability/psychological concern about response of SO
  • Disruption of sexual response pattern, e.g., erectile difficulty

Possibly evidenced by

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  • Not applicable. 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 verbalize understanding of relationship of physical condition to sexual problems.
  • Client will identify satisfying/acceptable sexual practices and explore alternative methods.
  • Client will resume sexual relationship as appropriate.
Nursing InterventionsRationale
Determine patient’s/SO’s sexual relationship before the disease and/or surgery and whether they anticipate problems related to the presence of ostomy.Identifies future expectations and desires. Mutilation and loss of privacy and/or control of a bodily function can affect the patient’s view of personal sexuality. When coupled with the fear of rejection by SO, the desired level of intimacy can be greatly impaired. Sexual needs are very basic, and the patient will be rehabilitated more successfully when a satisfying sexual relationship is continued and/or developed as desired.
Review with the patient and/or SO sexual functioning in relation to own situation.Understanding if nerve damage has altered normal sexual functioning helps patient/SO to understand the need for exploring alternative methods of satisfaction.
Reinforce the information given by the physician. Encourage questions. Provide additional information as needed.Reiteration of data previously given assists patient/SO to hear and process the knowledge again, moving toward acceptance of individual limitations or restrictions and prognosis (that it may take up to 2 yr to regain potency after a radical procedure or that a penile prosthesis may be necessary).
Discuss the likelihood of a resumption of sexual activity in approximately 6 wk after discharge, beginning slowly and progressing (cuddling, caressing until both partners are comfortable with body image and/or function changes). Include alternative methods of stimulation as appropriate.Knowing what to expect in progress of recovery helps the patient avoid performance anxiety and/or reduce the risk of “failure.” If the couple is willing to try new ideas, this can assist with adjustment and may help to achieve sexual fulfillment.
Encourage dialogue between partners. Suggest wearing pouch cover, T-shirt, shortie nightgown, or underwear sexual activity.Disguising ostomy appliance may aid in reducing feelings of self-consciousness, embarrassment during specifically designed for sexual contact.
Stress awareness of factors that might be distracting (unpleasant odors and pouch leakage). Encourage use of a sense of humor.Promotes resolution of solvable problems. Laughter can help individuals deal more effectively with a difficult situation, promote positive sexual experience.
Problem-solve alternative positions for coitus.Minimizing the awkwardness of appliance and physical discomfort can enhance satisfaction.
Discuss or role play possible interactions or approaches when dealing with new sexual partners.Rehearsal is helpful in dealing with actual situations when they arise, preventing self-consciousness about “different” body image.
Provide birth control information as appropriate and stress that impotence does not necessarily mean the patient is sterile.Confusion may exist that can lead to an unwanted pregnancy.
Arrange a meeting with an ostomy visitor if appropriate.Sharing of how these problems have been resolved by others can be helpful and reduce a sense of isolation.
Refer to sex counseling or therapy if appropriate.If problems persist longer than several months after surgery, a trained therapist may be required to facilitate communication between patient and SO.
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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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