Question

The nurse is caring for a client with an ileostomy. The nurse should pay careful attention to care around the stoma because: A. Digestive enzymes cause skin breakdown. B. Stools are less watery and contain more solid matter. C. The stoma will heal more slowly than expected. D. It is difficult to fit the appliance to the stoma site.

Short answer

Answer: The primary reason proper care around the stoma for a client with an ileostomy is crucial is that digestive enzymes in the ileostomy output can cause skin breakdown. Proper care helps to prevent skin irritation, infection, and other potential complications.

Step-by-step solution

Understanding the ileostomy and stoma

An ileostomy is a surgical procedure that creates an opening (stoma) in the abdomen for the small intestine (ileum) to pass waste outside of the body. The stoma is a small, pinkish-red, and moist opening which is created by bringing the end of the small intestine through an incision in the abdominal wall. Consequently, the care around the stoma is crucial to prevent potential complications such as infection, skin irritation, or breakdown.

Analyzing answer choice A

Digestive enzymes cause skin breakdown. This answer choice is accurate because the ileostomy bypasses the large intestine, where most of the water is absorbed back into the body. As a result, the ostomy output (stool) is mostly liquid and contains digestive enzymes that can be highly irritating to the skin around the stoma. If not properly managed, this can lead to skin breakdown, making answer choice A the correct option.

Analyzing answer choice B

Stools are less watery and contain more solid matter. This statement is actually the opposite of the reality of an ileostomy. As mentioned in the explanation of answer choice A, the output from an ileostomy tends to be more liquid as it bypasses the large intestine, where water absorption takes place. Therefore, answer choice B is incorrect.

Analyzing answer choice C

The stoma will heal more slowly than expected. This statement is not necessarily true, as the healing process of the stoma depends on individual factors such as overall health, nutrition, and post-operative care. While some stomas may take longer to heal than others, this is not directly related to ileostomy care. Thus, answer choice C is not the best answer.

Analyzing answer choice D

It is difficult to fit the appliance to the stoma site. While it can be true that finding the right fit for an ileostomy appliance can be challenging, this does not necessarily relate directly to the care needed around the stoma to prevent complications like skin irritation or infection. Proper care of the stoma includes cleaning the skin, inspecting for changes, and using appropriate ostomy supplies. Therefore, answer choice D is not the best response to the question.

Conclusion

The correct answer choice for the given exercise is A: Digestive enzymes cause skin breakdown. The reasoning for this answer lies in the fact that the output from an ileostomy is mostly liquid and contains digestive enzymes that can be irritating to the skin around the stoma. Proper care is crucial in preventing skin breakdown and promoting overall stoma health.