Nurse Bea should instruct the male client with an ileostomy to report immediately which of the following symptoms?
A. Absence of drainage from the ileostomy for 6 or more hours
B. Passage of liquid stool in the stoma
C. Occasional presence of undigested food
D. A temperature of 37.6 °C
Correct Answer: A. Absence of drainage from the ileostomy for 6 or more hours
Sudden decrease in drainage or onset of severe abdominal pain should be reported immediately to the physician because it could mean that obstruction has been developed. Sometimes the ileostomy does not function for short periods of time after surgery. This is not usually a problem, but if the stoma is not active for more than 6 hours and the patient experiences cramps or nausea, he may have an obstruction.
Option B: Passage of a moderate amount of stool in the stoma is expected during the first few days after surgery. With no large intestine to absorb as much water from it, stool becomes thinner. Stools may thicken up as the body adapts and the small intestine starts to absorb more water, but this is something that happens long-term. At first, the stool will be thin and output may be high.
Option C: As the body gets used to the stoma and ileostomy, the presence of undigested food every now and then can be normal. However, this piece of food might obstruct the stoma and cause abdominal pain and swelling. Avoid solid foods for the time being and drink plenty of water.
Option D: 37.6ºC is more than the normal range of temperature. Nursing interventions such as a tepid sponge bath may be done to decrease the temperature to the normal range. Pouchitis is when an internal pouch becomes inflamed. It’s a common complication in people with an ileo-anal pouch.