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

The creation of an ileostomy is a major physical change, involving a stoma on the abdomen and the need for an external pouch to collect waste.
This alteration directly impacts a person's perception of their own body, which is the definition of body image.
Psychosocial adjustment, including coping with changes in self-esteem, body image, and sexuality, is a universal challenge for patients after ostomy surgery.
While physiological issues like fluid balance are critical, the psychological impact on body image is a guaranteed concern for every patient, making it a common and priority nursing diagnosis.

Option B: Patients with an ileostomy are at high risk for fluid volume DEFICIT, not excess. The colon, which absorbs the majority of water from stool, is bypassed, leading to high-output, liquid effluent and significant fluid loss.
Option C: The output from an ileostomy is liquid to semi-liquid because it does not pass through the large intestine for water absorption and solidification. Therefore, constipation is not a physiological possibility.
Option D: This diagnosis is specific to children and adolescents whose physical growth and psychosocial development may be impacted by a chronic illness and major surgery. It is not applicable to the entire population of patients with ileostomies, which includes many adults.

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 facilitate coping with the stoma. This includes connecting patients with Wound, Ostomy, and Continence (WOC) nurses and peer support groups.
Patient education is critical for preventing complications. Teaching about pouching, peristomal skin care, and signs of dehydration empowers the patient to manage their condition effectively.
What if? If the patient is an adolescent, the nursing diagnosis of Disturbed Body Image becomes even more critical. Interventions would need to be tailored to address concerns about peer acceptance, social activities, and intimacy, which are central developmental tasks during this life stage.

How to Approach the Question

First, identify the key concept in the question: a 'common nursing diagnosis' for 'all patients with an ileostomy'. The word 'all' is crucial, meaning the diagnosis must be universally applicable.
Next, analyze the pathophysiology of an ileostomy. Recall that it diverts stool from the small intestine, bypassing the large intestine (colon). This means stool will be liquid and high in volume.
Evaluate each option based on this pathophysiology. 'Excess fluid volume' and 'Constipation' are physiologically incorrect due to the nature of ileostomy output.
Compare the remaining options. 'Delayed growth and development' is specific to a pediatric population, so it does not apply to 'all' patients.
'Disturbed body image' relates to the psychosocial impact of having a stoma, which is a universal experience for any person undergoing this life-altering surgery, regardless of age.
Therefore, Disturbed Body Image is the most common and universally applicable nursing diagnosis from the choices provided.

Concept Tested & Keywords

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

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