Question

The client with an ileostomy is being discharged. Which teaching should be included in the plan of care? A. Use Karaya powder to seal the bag. B. Irrigate the ileostomy daily. C. Stomahesive is the best skin protector. D. Neosporin ointment can be used to protect the skin.

Short answer

A. Use Karaya powder to seal the bag. B. Irrigate the ileostomy daily. C. Stomahesive is the best skin protector. D. Neosporin ointment can be used to protect the skin. Answer: C. Stomahesive is the best skin protector.

Step-by-step solution

Review the choices

First, we need to review and understand each option provided (A, B, C, D). A. Use Karaya powder to seal the bag. B. Irrigate the ileostomy daily. C. Stomahesive is the best skin protector. D. Neosporin ointment can be used to protect the skin.

Evaluate each choice

Next, we will evaluate the appropriateness of each option based on evidence-based practices and guidelines for ileostomy care. A. Karaya powder can be used to absorb moisture and prevent skin irritation for individuals with an ostomy. It's a helpful teaching for care, but there are more important teachings that should be included. B. Irrigating the ileostomy daily is not a necessary practice for ileostomies. Intestinal irrigation is typically done for colostomies, not ileostomies. C. Stomahesive is a skin barrier and protective paste that helps prevent skin irritation and promotes skin healing. It's very important for ileostomy care since the output contains digestive enzymes that can cause skin irritation. D. Neosporin ointment can be used for wound care, but it's not specifically designed for ileostomy skin protection. It might not be as effective in preventing skin irritation compared to products specifically designed for ostomy care.

Choose the best teaching for the plan of care

Based on the evaluation of each option, the teaching that should be included in the plan of care is: C. Stomahesive is the best skin protector. This teaching is the most appropriate because Stomahesive offers specific and effective protection against skin irritation caused by ileostomy output. Other options are either not necessary or not as effective in ileostomy care.

Key concepts

Ostomy education

Learning about ostomy care is crucial for anyone who has had an ileostomy. This type of surgery involves creating an opening in the abdominal wall to allow waste to exit the body through a stoma. Comprehensive ostomy education helps patients feel more confident in managing their new lifestyle.
Understanding the importance of proper appliance use and hygiene practices is key. It helps in preventing infections and skin complications. Patients should become familiar with the different types of ostomy supplies available, such as pouches and skin barriers, to find the products that fit best for their needs.

• Recognize signs of possible complications, like skin irritation.
• Practice regular cleaning and changing of ostomy appliances.
• Understand how to secure the appliance to prevent leaks.

Overall, education empowers patients to take control of their health and quickly adapt to new routines.

Skin protection for ileostomy

Protecting the skin around the stoma is crucial due to the constant exposure to digestive enzymes that can cause irritation. There are effective ways to keep the skin healthy and irritation-free.
Firstly, using a reliable protective barrier is essential. Products like Stomahesive are specially designed to provide a protective layer between the skin and digestive enzymes. They help minimize irritation and promote healing if any skin issues occur.

• Apply the skin barrier before attaching the ostomy bag.
• Use powders to absorb moisture and prevent skin breakdown.
• Avoid using products not specifically designed for ostomy care, like Neosporin, which may not provide adequate protection.

Consistent care and appropriate product selection are key to ensuring skin health around the ileostomy.

Patient discharge instructions

Preparing for discharge involves more than just packing up belongings; it requires a clear understanding of at-home care for your ileostomy. Providers should give comprehensive instructions to ensure a smooth transition back home.
Key instructions should include:

• How to change ostomy appliances and how often to do so.
• The importance of keeping the stoma and surrounding skin dry and clean.
• Signs of infection or complications, and when to seek medical advice.
• Tips on integrating the care into daily life and routines.

These instructions need to be easy to understand and tailored to each individual patient to facilitate self-care and help prevent readmissions due to complications.