Question

A nurse is teaching a patient with a new ileostomy about incorporating preventive strategies at home. To prevent excoriation and breakdown of the peristomal skin, the nurse should instruct the patient to

A) Cleanse the peristomal skin with hot water and strong soap.

B) Use adhesive remover wipes before applying the pouching system.

C) Change the pouching system only when it leaks.

D) Allow the peristomal skin to air dry thoroughly before applying a new pouch.

Answer 1

The nurse should advise the patient with a new ileostomy to allow the peristomal skin to air dry thoroughly before applying a new pouch, use lukewarm water and mild soap for cleansing, avoid irritating substances, and change the pouch on a regular schedule.

Step-by-step explanation:

To prevent excoriation and breakdown of the peristomal skin, the nurse should instruct the patient with a new ileostomy to allow the peristomal skin to air dry thoroughly before applying a new pouch. It is important to avoid hot water and strong soaps, as these can irritate the skin. Additionally, adhesive remover wipes should be used carefully, as frequent use can also irritate the skin. The pouching system should be changed on a regular schedule, not only when it leaks, as waiting for a leak can result in skin exposure to potentially irritating contents.

Good hygiene practices and proper wound care are essential. The peristomal area should be cleansed with lukewarm water and mild soap, and completely dried before applying a new pouch to prevent moisture from becoming trapped against the skin, which can lead to infection or irritation.

Moreover, using alcohol-free products is critical because alcohol can dry out and damage the skin. It is also beneficial to avoid any products that may further irritate the skin, like astringents or exfoliants.