What is an Ileostomy?
An
ileostomy is a surgical procedure that creates an opening (stoma) in the abdominal wall to allow the passage of stool from the small intestine (ileum) to the outside of the body. This procedure is typically necessary when the lower part of the digestive tract is not functioning properly due to conditions such as
Crohn's disease,
ulcerative colitis, or cancer.
Preoperative Care
Before the surgery, nurses play a critical role in preoperative care. This involves educating the patient about the procedure, assessing their understanding, and providing emotional support. Nurses must ensure that the patient has undergone necessary preoperative tests and that they are prepared both physically and mentally for the operation. This includes discussing potential
complications and postoperative care.
Postoperative Care
After the surgery, postoperative care is vital for recovery. Nurses must monitor the patient’s vital signs, manage pain, and observe for signs of infection or other complications. Proper stoma care is essential to prevent skin irritation and infection. Nurses should educate the patient on how to clean and care for the stoma, and how to apply and change the
ostomy appliances.
Nutritional Considerations
Post-ileostomy, patients often need to adjust their diets. Nurses should provide guidance on nutritional needs, focusing on foods that are easy to digest and less likely to cause blockages. Hydration is also crucial, as patients with an ileostomy can lose fluids and electrolytes more quickly. Advising on high-protein and high-calorie diets can help in recovery and maintaining energy levels.Psychosocial Support
An ileostomy can significantly impact a patient’s quality of life and self-image. Nurses should offer continuous psychosocial support and refer patients to
support groups or counseling services. Educating the patient and their family about living with an ileostomy can alleviate anxiety and promote a positive outlook.
Complication Management
Nurses must be vigilant in identifying and managing complications such as stoma prolapse, retraction, and skin irritation. Immediate intervention is necessary to address issues like dehydration, electrolyte imbalance, and bowel obstruction. Nurses should also educate patients on recognizing signs of complications and when to seek medical help.Patient Education and Follow-up
Educating patients on long-term care is essential for their independence and well-being. This includes training on stoma care, diet modifications, and recognizing complications. Regular follow-up appointments are necessary to monitor the patient's progress and address any concerns. Nurses should provide resources and contacts for additional support.Conclusion
In the context of nursing, managing a patient with an ileostomy involves comprehensive care from preoperative preparation to long-term follow-up. Nurses play a pivotal role in education, emotional support, and complication management, ensuring that patients adapt well to their new lifestyle and maintain a high quality of life.
