ILEOSTOMY CARE.pdf Nursing Education Year 2

ILEOSTOMY CARE

1. NURSES’ TRAINING COLLEGE HO
ADVANCE NURSING 2
PRESENTATION 1
TUTOR’s: SISTER RITA DODZI & SISTER REBECCA
ABITI

2. ILEOSTOMY CARE
By the end of this presentation, Student will be able to
explain
•Ileostomy.
•Types of Ileostomy.
•Purpose of ileostomy.
•Indication of Ileostomy.
•Contraindication of ileostomy.
•Care of Ileostomy.
•Nursing management before, during and after
procedure.
•Complications of ileostomy

4. WHAT IS ILEOSTOMY
•It's a surgical procedure done to create an opening in the
abdominal wall to allow for passage of stool to bypass a
blockage or a disease portion of the bowel. It is done in
the right lower quadrant. It may be permanent or
reversible. Its fecal matter is green or yellow liquid which
is rich in digestive enzymes, electrolytes and water.
•After surgery, petroleum gauze is used to keep moist and
sterile dry dressing used when pouch is fixed to drain
stool.

5. PURPOSE OF ILEOSTOMY.
•The purpose of ileostomy care is to ensure the proper management
of the stoma and surrounding skin after a surgical procedure where the
ileum (part of the small intestine) is diverted to an opening in the
abdominal wall. Key goals include:
•Preventing Infection: Proper cleaning and maintenance of the
stoma area reduce the risk of infections and complications.
• Skin Protection: Stoma output contains digestive enzymes that
can irritate the skin. Proper care helps to prevent skin irritation and
breakdown.
• Promoting Comfort: Adequate care helps reduce discomfort,
leaks, or odor, improving the patient’s quality of life.
• Maintaining Appliance Functionality: Regular emptying and
changing of the ostomy bag ensures the appliance works properly,
preventing leaks or blockages.
• Monitoring Health: Ileostomy care involves checking for any
signs of complications, such as stoma swelling, unusual discharge,
or changes in color that could indicate a problem. In general, the
goal is to ensure the patient can live comfortably and maintain
normal daily activities.

6. Types of Ileostomies
•- End ileostomy: Most common type, where the ileum is
brought through the abdominal wall.
•- Loop ileostomy: A temporary ostomy, where a loop of
ileum is brought through the abdominal wall.
•- Double-barrel ileostomy: Two separate openings, one for
fecal matter and one for mucus

8. Indications
1. Inflammatory bowel disease (IBD):
• - Ulcerative colitis
• - Crohn's disease
2. Cancer:
• - Colon cancer
• - Rectal cancer
• - Anal cancer
3. Bowel obstruction
4. Trauma:
• - Gunshot wounds
• - Stab wounds
• - Blunt trauma

9. 5. Infections:
• - Abscesses
• - Fistulas
• - Peritonitis
6. Intestinal failure
7. Short bowel syndrome

10. Contraindications
• 1. Unstable or uncontrolled bleeding disorders (e.g.,
hemophilia)
•2. Severe intestinal ischemia or infarction
•3. Unresectable intestinal tumors
•4. Active intestinal fistulas
•5. Severe intestinal adhesions
•6. Dehydration
•7. Electrolytes imbalance

11. CARE OF ILEOSTOMY
This include;
STOMA CARE
•Clean gently with warm water and gauze.
•Avoid using soaps that contain oils or
fragrance (cause skin irritation).
•Regular check stoma for any changes in
color, size or condition.(stoma should be
pink or red).
SKIN CARE
•Use skin barriers or pouch that fit well, in
order to protect the skin around the stoma.
•Apply thick ring of ostomy paste around
stoma, to help create a better seal and
prevent leaks.

12. CARE OF
ILLEOSTOMY
CON’T
POUCH MANAGEMENT
•Empty pouch when it is one third full.
•Change pouch regularly 3 to 7 days.
DIET
•Avoid gas food; such beans, cabbage
etc.
•Drink plenty of water to stay hydrated.
•Lower the intake of fiber rich foods
like raw corn etc.
•Food should bland and in liquid form.
LIFESTYLES
•Avoid heavy lifting.
•Avoid strenuous activity.

13. REQUIREMENTS
•New stoma pouch
• Gloves
•Wipes or tissue
•Measuring template
•Gallipot with gauze
swabs.
•Mackintosh and dressing
towel
•Bowl of tepid water
•Large receiver
•Deodorizer
•Soap or mild detergent
•Scissors.

14. NURSING RESPONSIBILITY BEFORE, DURING
AND AFTER THE PROCEDURE .
Before
•- Inform patient about the procedure
•- Obtain informed consent
•- Educate patient on the type of operation, the look, location
and the type of pouch to be used during the procedure
•- Educate patient on the need of undergoing the procedure,
and what role the patient will play
•- Reassure the patient to allay fear and anxiety
•- Monitor vital signs as baseline data and also since they are
vital indication to tell how well organs or body functions
•- Review on patient medical condition, treatment and
medication patients are on before surgery
•- Set intravenous lines.

15. •- encourage patient not to eat nothing by mouth
•- encourage patient to void
•- let patient remove all jewelry, dentures or things that
can alter the procedure
•- make patient change into the hospital patient clothing
•- Put patient in the supine position
DURING THE PROCEDURE.
•1. Monitor vital signs (BP, HR, RR, SpO2).
•2. Maintain patient's positioning and comfort.
•3.Maintain asepsis and prevent infection.
•4.provide the physician with the necessary equipment
and supplies
•5.Assist in skin prepping and draping of the patient
•6.Providing emotional support and reassurance to the
patient

16. POST OR AFTER
•Monitor vital signs, electrolytes and signs of dehydration
•Monitor stoma and surrounding skin for any complications
•Monitor color of stool
•Encourage patient to report burning or leaking around the site
•Educate patient to eat food low in fiber, chew food thoroughly,
follow regular diet and maintain hydration
•Educate patient to avoid food hard to digest or take in smaller
portions, since it can block the stoma. e.g. maize, peas, popcorn,
nut and seeds, raw mushrooms pineapple, raisins
•Teach patient on how to care for the stoma and pouching system
•Empty pouch when ⅓ to ½ full into a commode
•Change pouch system every 3 to 5 days
•Change pouch when gut are less reactive( before breakfast)

17. Complications
• Dehydration
•Electrolytes imbalance
•Skin irritation and breakdown around stoma
•Pouching system leaks or difficulties
•Stoma prolapse or retraction
•Infectionsorabscesses

18. Conclusion
Proper care of ileostomy is very
important, for maintaining skin
health, preventing complications, and
ensuring a good quality of life.
Regular monitoring, effective pouch
management and dietary
considerations are all essential
components of successful ileostomy
care.

19. •REFERENCE: Berti-Hearn L,
Elliott B. Ileostomy care: A guide
for home care clinicians.Home
Healthcare Now.2019; 37(3):136-
144.
GROUP MEMBERS
Acheampong Andrews
Adjei Benjamin
Dorcoo Dorcas
Zikpi Etornam Rabby
Eunice Frimpong
Kwapong Ansaa Jennifer
Magdalene Mensah