Which statement by a patient with an ileostomy alerts nurse to need for furr education?

Correct Answer: C. “I’m going to have to irrigate my stoma so I have a bowel movement every morning”

This statement is inaccurate in relation to an ileostomy and indicates that the patient needs more teaching. An ileostomy produces liquid fecal drainage that is constant and cannot be regulated. An ileostomy is when the lumen of the ileum (small bowel) is brought through the abdominal wall via a surgical opening (created by an operation). This can either be temporary or permanent, an end or a loop. The purpose of an ileostomy is to evacuate stool from the body via the ileum rather than the usual route of the anus.

• Option A: The odor from drainage is minimal because fewer bacteria are present in the ileum compared with the large intestine. There are different indications for forming an ileostomy but essentially arrive at the same result of diverting stool out of the body without it ever entering the colon.
• Option B: An ileostomy is an opening into the ileum (distal small intestine from the jejunum to the cecum). Cleansing the skin, skin barriers, and a well fitted appliance are precautions to protect the skin around the ileostomy stoma. The drainage from ileostomy contains enzymes that can damage the skin.
• Option D: An ileostomy stoma does not have a sphincter that can control the flow of flatus or drainage, resulting in noise. The output from an ileostomy consists of loose or porridge-like stool consistent with that expected to pass through the small bowel (as it is the large bowel that is responsible for making the stool more solid dependent upon water absorption). The output from an ileostomy can vary but typically ranges from 200 to 700 ml per day, and an Ileostomy is typically formed on the right side of the abdomen.