A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful.
Many people suffer from bladder cancer. Sometimes, the bladder must be removed due to the cancer. In this case, then the surgeon will create a urine diversion so that the urine can be stored and empties. There are a few different ways that this can take place. An ileal conduit urine diversion rewires the ureters from the bladder to the end of the small intestines.
The urine is contained in a bag located outside of the body over the opening or stoma. If a nurse has a bladder removal patient with a stoma, she may have to change the client’s pouch. If she notices that the stoma area is red and infected, she may realize that the faceplate for the urine pouch doesn’t fit the stoma.
Rrationale: If the pouch faceplate doesn't fit the stoma properly, the skin around the stoma will be exposed to continuous urine flow from the stoma, causing excoriation and red, weeping, and painful skin. Alubricant shouldn't be used because it would prevent the pouch from adhering to the skin. When properly applied, a skin barrier prevents skin excoriation. Stoma dilation isn't performed with an ileal conduit, although it may be done with a colostomy if ordered.