Within the past 50 years major advances have occurred in ostomy surgery, including continent diversions such as the Kock pouch and the ileoanal reservoir. However, each year in the United States, 100,000 people still undergo surgery to create ostomies. These so-called incontinent diversions are the primary focus of this plan of care.
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.
A 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.
CARE SETTING
Inpatient acute care surgical unit.
RELATED CONCERNS
Cancer
Fluid and electrolyte imbalances, see Nurse Care Plan CD-ROM
Inflammatory bowel disease: ulcerative colitis, regional enteritis
Psychosocial aspects of care
Surgical intervention
Total nutritional support: parenteral/enteral feeding
Patient Assessment Database
Data depend on the underlying problem, duration, and severity (e.g., obstruction, perforation, inflammation, congenital defects).
TEACHING/LEARNING
Discharge plan
DRG projected mean length of inpatient stay: 9.4 days
Assistance with dietary concerns, management of ostomy, and acquisition of supplies may be required
Refer to section at end of plan for postdischarge considerations.
NURSING PRIORITIES
1. Assist patient/SO in psychosocial adjustment.
2. Prevent complications.
3. Support independence in self-care.
4. Provide information about procedure/prognosis, treatment needs, potential complications, and community
resources.
DISCHARGE GOALS
1. Adjusting to perceived/actual changes.
2. Complications prevented/minimized.
3. Self-care needs met by self/with assistance depending on specific situation.
4. Procedure/prognosis, therapeutic regimen, potential complications understood and sources of support identified.
5. Plan in place to meet needs after discharge.
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.
A 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.
CARE SETTING
Inpatient acute care surgical unit.
RELATED CONCERNS
Cancer
Fluid and electrolyte imbalances, see Nurse Care Plan CD-ROM
Inflammatory bowel disease: ulcerative colitis, regional enteritis
Psychosocial aspects of care
Surgical intervention
Total nutritional support: parenteral/enteral feeding
Patient Assessment Database
Data depend on the underlying problem, duration, and severity (e.g., obstruction, perforation, inflammation, congenital defects).
TEACHING/LEARNING
Discharge plan
DRG projected mean length of inpatient stay: 9.4 days
Assistance with dietary concerns, management of ostomy, and acquisition of supplies may be required
Refer to section at end of plan for postdischarge considerations.
NURSING PRIORITIES
1. Assist patient/SO in psychosocial adjustment.
2. Prevent complications.
3. Support independence in self-care.
4. Provide information about procedure/prognosis, treatment needs, potential complications, and community
resources.
DISCHARGE GOALS
1. Adjusting to perceived/actual changes.
2. Complications prevented/minimized.
3. Self-care needs met by self/with assistance depending on specific situation.
4. Procedure/prognosis, therapeutic regimen, potential complications understood and sources of support identified.
5. Plan in place to meet needs after discharge.
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