The home health nurse pouches the enterostomy for the client who has serious financial constraints. Which should the nurse implement to pouch the enterostomy?

Question

1. Uses soap and warm water for peristomal cleansing
2. Leaves an intact skin barrier in place for 3 to 5 days
3. Punches several holes in the pouch for flatus to escape
4. Uses a firm pouching system on a round, hard abdomen

Answer 1

2
2. The nurse leaves a functioning skin barrier in place to change the client's ente-rostomy pouch to avoid unnecessary waste of ostomy supplies and helps the client find community resources for assistance procuring needed supplies.
1. The nurse avoids using soap for peristomal cleansing because it can leave a residue on the skin to impair the protective properties of the skin barrier, leading to skin breakdown.
3. The nurse avoids punching holes in the pouch because this allows intestinal gas to drift out of the pouch; the client is likely to notice the odor, change the pouch to re-duce odor, and incur needless expense by wasting a pouch.
4. A firm, round abdomen requires a softer, more flexible pouch system to secure the skin barrier.