AIIMS Manglagiri NO -…: A common nursing diagnosis for all patients with an ileostomy is:-

AIIMS Manglagiri NO - 2019

Medical & Surgical Nursing

Medium

Appeared in: AIIMS Manglagiri NO - 2019

Explanation

An ileostomy creates a stoma, a significant physical alteration on the abdomen, which universally requires psychological adjustment.
The presence of an external pouch to collect stool can lead to feelings of embarrassment, social isolation, and concerns about appearance and odor, directly impacting self-esteem and body image.
Coping with a new stoma is a major psychosocial challenge for patients, making 'Disturbed Body Image' a priority diagnosis to address emotional well-being and facilitate adaptation.
Unlike potential physiological complications, the psychological impact of a changed body is a near-universal experience for patients with a new ostomy.

Option B: Patients with an ileostomy lose large amounts of fluid and electrolytes through their stoma because the stool bypasses the water-absorbing colon. Therefore, they are at high risk for Deficient Fluid Volume, not Excess Fluid Volume.
Option C: Constipation is the infrequent or difficult passage of hard, dry stool. This is physiologically impossible for a patient with an ileostomy, as their output is consistently liquid-to-pasty because it has not passed through the colon.
Option D: This diagnosis is not applicable to all patients with an ileostomy. It is specific to children or adolescents whose physical growth and maturation may be affected by a chronic underlying disease (like Crohn's disease) that necessitated the ileostomy.

Clinical Relevance

Nursing practice connection: Use the key finding related to Common nursing diagnoses for patients with an ileostomy to guide bedside assessment, documentation, and the next nursing action.
A primary nursing role is to provide emotional support and create a safe environment for patients to express their feelings about the stoma.
Patient education on stoma care, pouching systems, and diet is crucial for empowering the patient, which in turn improves self-esteem and helps them adapt to their new body image.
Referring patients to ostomy support groups or a Wound, Ostomy, and Continence Nurse (WOCN) can provide valuable peer support and expert guidance, facilitating long-term coping.

How to Approach the Question

First, analyze the question's core components: it asks for a 'common' nursing diagnosis for 'all' patients with an ileostomy.
The keyword 'all' is critical. It directs you to find a diagnosis that is universally applicable, rather than a potential complication or a problem specific to a subset of patients.
Evaluate each option based on the pathophysiology of an ileostomy.
Consider both physiological and psychosocial aspects. An ileostomy has definite physiological consequences (fluid loss, liquid stool) and significant psychosocial consequences (body change).
Eliminate options that are physiologically incorrect. 'Excess fluid volume' and 'Constipation' are direct contradictions of ileostomy function.
Eliminate options that are not universal. 'Delayed growth and development' is specific to a pediatric population.

Concept Tested & Keywords

QZgeNfyCJIrN9kx9DjMqSS

E6 Nursing Fundamentals Taylor pp. 562-564, 620-622

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 45-47