A client with an ileal conduit reports that the appliance won't adhere and the stoma area is red, moist, and tender to touch. What is the most appropriate nursing intervention?

A client with an ileal conduit reports that the appliance won't adhere and the stoma area is red, moist, and tender to touch. What is the most appropriate nursing intervention?

• A. Consult the wound-ostomy nurse.
• B. Replace the pouching system immediately.
• C. Apply antibiotic ointment under the skin barrier.
• D. Instruct the client to adjust the appliance fit herself.

Answer: (A)

This situation shows peristomal skin irritation and a problematic appliance fit, which requires expert assessment. A wound-ostomy nurse has specialized training to evaluate the stoma, surrounding skin, and the fit of the appliance, then guide changes to the barrier, flange size, or adhesive to protect the skin and restore adhesion. Simply replacing the pouching system may not address the underlying cause of the irritation and could worsen skin breakdown. Applying antibiotic ointment under the barrier could mask a skin issue or cause further irritation, and having the client adjust the fit themselves risks improper technique and damage. Involving the wound-ostomy nurse ensures a proper, skin-safe solution tailored to the patient’s stoma and peristomal skin.

This situation shows peristomal skin irritation and a problematic appliance fit, which requires expert assessment. A wound-ostomy nurse has specialized training to evaluate the stoma, surrounding skin, and the fit of the appliance, then guide changes to the barrier, flange size, or adhesive to protect the skin and restore adhesion. Simply replacing the pouching system may not address the underlying cause of the irritation and could worsen skin breakdown. Applying antibiotic ointment under the barrier could mask a skin issue or cause further irritation, and having the client adjust the fit themselves risks improper technique and damage. Involving the wound-ostomy nurse ensures a proper, skin-safe solution tailored to the patient’s stoma and peristomal skin.