Question

A nurse is preparing to administer a cleansing enema to a patient who is prone to fecal incontinence due to poort sphincter control and is unlikely to retain the enema solution. Which of the following interventions is appropriate for this patient?

Answer 1

For patients with poor sphincter control, performing an ileostomy may be an appropriate intervention to manage fecal incontinence. Such an intervention bypasses the need for sphincter control by allowing fecal matter to be collected in an external bag.

Step-by-step explanation:

When administering a cleansing enema to a patient with poor sphincter control, the nurse must consider the likelihood that the patient will not be able to retain the enema solution. Given the difficulty in retaining the fluid, alternative methods to manage fecal incontinence should be explored. One possible approach might involve the use of a more permanent solution such as constructing a new fecal pouch or performing an ileostomy.

An ileostomy is a surgical procedure where the end of the small intestine (the ileum) is brought through the abdominal wall. Fecal matter is then passed directly into an adhesive bag, avoiding the need for sphincter control. Although creating an ileostomy is a significant intervention, it may provide a more manageable and dignified solution for fecal incontinence for those with poor sphincter control.

In any case, nurses must be proficient in understanding the anatomy involved and be able to provide detailed education and support to the patient concerning the care and management of an ileostomy.

For patients unlikely to retain an enema solution due to poor sphincter control, an ileostomy provides a viable long-term solution to manage fecal incontinence. This procedure allows waste to bypass the compromised sphincter and be collected in an external appliance.