1158

SECTION 9 Problems of Urinary Function

NURSING CARE PLAN 46-3

Patient with an Ileal Conduit
NURSING DIAGNOSIS
PATIENT GOALS

Anxiety related to anticipated effects of ileal conduit on lifestyle and relationships and lack of knowledge regarding surgical
procedure as evidenced by frequent questions about surgical procedure, restlessness, inattention, and difficulty concentrating
1. Reports decreased anxiety regarding the effects of surgery on lifestyle
2. Verbalizes understanding of surgical procedure and postoperative expectations

OUTCOMES (NOC)
Preprocedure Readiness

INTERVENTIONS (NIC) AND RATIONALES

Teaching: Preoperative

Appraise the patients/caregivers anxiety relating to surgery to plan appropriate interventions.

Determine the patients expectations of the surgery to clarify misconceptions as needed.
Provide time for the patient to ask questions and discuss concerns to increase patient
understanding of the procedure.
Describe the preoperative and postoperative routines to reduce fear of the unknown.
Instruct the patient to use coping techniques directed at controlling specific aspects of the
experience (e.g., relaxation, imagery) as appropriate to increase patients sense of control.

Knowledge of procedure _____

Knowledge of preprocedure routines _____
Knowledge of postprocedure routines _____
Identification of changes in health status _____
Discussion of concerns about procedure _____

Measurement Scale

1 = Not adequate
2 = Slightly adequate
3 = Moderately adequate
4 = Substantially adequate
5 = Totally adequate

Anxiety Self-Control
Seeks information to reduce anxiety _____
Uses effective coping strategies _____

Anxiety Reduction
Provide factual information concerning diagnosis, treatment, and prognosis to reduce fear of the
unknown and convey a caring attitude.
Assist patient to articulate a realistic description of an upcoming event to reduce anxiety and
promote decision making.
Instruct patient in use of relaxation techniques to promote coping.

Measurement Scale

1 = Never demonstrated
2 = Rarely demonstrated
3 = Sometimes demonstrated
4 = Often demonstrated
5 = Consistently demonstrated

NURSING DIAGNOSIS
PATIENT GOALS

Disturbed body image related to effects of change in body function on lifestyle or relationships as evidenced by negative
feelings about self, refusal to look at or touch stoma or participate in self-care, expression of concern about effect on family
and lifestyle
1. Verbalizes acceptance of changes in body appearance and function
2. Participates in care of ileal conduit

OUTCOMES (NOC)
Body Image

INTERVENTIONS (NIC) AND RATIONALES

Body Image Enhancement

Help patient determine extent of actual changes in the body or its level of functioning to assist
with issues and misconceptions and plan appropriate interventions.
Monitor whether patient can look at changed body part to assess readiness to participate in selfcare.
Assist patient to separate physical appearance from feelings of personal worth to provide support
and convey a sense of worth.
Facilitate contact with individuals with similar changes in body image to provide patient with realistic experiences related to ostomy care.
Identify support groups available to patient as these resources may provide new information and
suggestion of ways to modify lifestyle.

Description of affected body part _____

Willingness to touch affected body part _____
Satisfaction with body function _____
Adjustment to changes in physical
appearance _____
Adjustment to changes in body function _____
Measurement Scale

1 = Never positive
2 = Rarely positive
3 = Sometimes positive
4 = Often positive
5 = Consistently positive

NURSING DIAGNOSIS Risk for impaired skin integrity related to need for chronic use of external appliance on skin or ill-fitting appliance
PATIENT GOAL Maintains intact, healthy skin around stoma
OUTCOMES (NOC)
INTERVENTIONS (NIC) AND RATIONALES
Tissue Integrity: Skin and Mucous
Ostomy Care
Apply appropriately fitting ostomy appliance to protect the skin from urine exposure.
Membranes
Skin lesions _____
Skin scaling _____
Erythema _____

Monitor stoma/surrounding tissue healing and adaptation to ostomy equipment to ensure prompt
identification of problems.
Change/empty ostomy bag to prevent urine leakage onto the skin.

Measurement Scale

Skin Care: Topical Treatments

1 = Severe
2 = Substantial
3 = Moderate
4 = Mild
5 = None

Refrain from using alkaline soap on the skin around the stoma to prevent alkaline accumulation on
the skin.