Practice Quiz

CMSRN Medical-Surgical Nursing

Category - Genitourinary

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Francis, a long time mechanic, has undergone creation of an ileal conduit. Which of the following instructions to the client about ostomy care would be appropriate to include in the teaching plan?
  1. Cut the faceplate of the appliance so that the opening is slightly smaller than the stoma
  2. Plan to do appliance changes just before bedtime
  3. Limit fluids to minimize odor from urine breakdown to ammonia
  4. Cleanse the skin around the stoma using gentle soap and water, rinse, and dry well
Explanation
Answer - D - Periostomal skin should be cleansed with each appliance change using a gentle soap and water and then should be rinsed and dried thoroughly. The client should change the appliance early in the morning, when urine production is slowest from lack of fluid intake during sleep. The opening of the appliance should be cut no longer than 3mm greater than the opening of the stoma; an opening smaller than the stoma would prevent proper application. Fluids are encouraged to dilute the urine and decrease the odor.
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