Question

A nurse is working with a patient who is learning to care for a continent ileostomy (Kock pouch). Following the initial period of healing, the nurse is teaching the patient how to independently empty the ileostomy. The nurse should teach the patient to do which of the following actions?

1) Aim to eventually empty the pouch every 90 minutes.
2) Avoid emptying the pouch until it is visibly full.
3) Insert the catheter approximately 5 cm into the pouch.
4) Aspirate the contents of the pouch using a 60 mL piston syringe.

Answer 1

The patient with a Kock pouch should be taught to carefully insert the catheter about 5 cm into their pouch to drain it properly. They should not wait until the pouch is full or aim to empty it every 90 minutes, nor use a piston syringe for aspiration.

Step-by-step explanation:

When teaching a patient how to independently empty a continent ileostomy or a Kock pouch, it is critical to provide accurate and clear instructions to ensure the patient can manage their own care safely and effectively. The correct action to teach the patient would specifically be to insert the catheter approximately 5 cm into the pouch to drain its contents. This depth allows for the effective emptying of the pouch without causing damage to the internal structure of the newly created internal reservoir.

It is not advisable for the patient to wait until the pouch is visibly full before emptying it, as this can cause discomfort and increase the risk of complications. Furthermore, the goal of emptying every 90 minutes is not typical for a continent ileostomy, nor is aspirating the contents using a 60 mL piston syringe a standard practice. The patient should be instructed on the proper frequency of emptying their specific type of stoma, which can be several times a day depending on individual circumstances, to maintain comfort and function.