Ileostomy
Surgical opening of the ileum through the abdominal wall
Definition
An ileostomy is a surgical opening bringing the end of the ileum (small intestine) to the abdominal surface. It bypasses the entire colon, producing liquid or semi-liquid stool.
Indications
- Ulcerative colitis or Crohn's disease
- Colorectal cancer
- Familial adenomatous polyposis
- Trauma, bowel perforation
Key Characteristics
Output is LIQUID and contains digestive enzymes that irritate the skin; high fluid and electrolyte loss; no control of output, typically located in the right lower quadrant.
Nursing Care
- Monitor fluid and electrolyte status closely (especially sodium and potassium)
- Goal output 500 to 1000 mL/day; greater than 1500 mL = dehydration risk
- Protect peristomal skin with barrier creams
- Empty pouch when 1/3 full
- Teach patients to avoid foods that cause blockage (corn, nuts, popcorn, stringy vegetables)
- Chew food thoroughly, hydrate well
- Medications: avoid enteric-coated/extended-release (will not be absorbed)
NCLEX Relevance
Liquid output, high dehydration risk. Skin protection critical.