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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Disturbed Sleep Pattern

Nursing Diagnosis

May be related to

  • External factors: necessity of ostomy care, excessive flatus/ostomy effluent
  • Internal factors: psychological stress, fear of leakage of pouch/injury to stoma

Possibly evidenced by

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  • Verbalizations of interrupted sleep, not feeling well rested
  • Changes in behavior, e.g., irritability, listlessness/lethargy

Desired Outcomes

  • Client will sleep/rest between disturbances.
  • Client will report an increased sense of well-being and feeling rested.
Nursing InterventionsRationale
Explain the necessity to monitor intestinal function in the early postoperative period.Patient is more apt to be tolerant of disturbances by staff if he or she understands the reasons for or importance of care.
Provide necessary pouching system. Empty pouch before retiring and on a pre-agreed schedule.Excessive flatus can occur despite interventions. Emptying on a regular schedule minimizes threat of leakage.
Let the patient know that stoma will not be injured when sleeping.Helps the patient to rest better if he is secure about stoma and ostomy function.
Restrict intake of caffeine-containing foods or fluid.Caffeine may delay the patient falling asleep and interfere with REM (rapid eye movement) sleep, resulting in patient not feeling well rested.
Support continuation of usual bedtime rituals.Promotes relaxation and readiness for sleep.
Determine the cause of excessive flatus or effluent. Confer with dietitian regarding restriction of foods if diet-related.Identification of cause enables the institution of corrective measures that may promote sleep/rest.
Administer analgesics, sedatives at bedtime as indicatedPain can interfere with a patient’s ability to fall or remain asleep. Timely medication can enhance rest and sleep during the initial postoperative period. Note: Pain pathways in the brain lie near the sleep center and may contribute to wakefulness.
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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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