Question

The nurse is caring for an older adult client with an ileostomy and hemiplegia secondary to a stroke experienced a few years ago. When changing the client's one-piece appliance, the nurse finds the skin under the skin barrier is ulcerated and erythematous. The client does not empty the pouch until it is completely full because it hurts so much to remove the skin barrier. Which action by the nurse is the priority?
1. Apply a two-piece ostomy appliance.
2. Treat the damaged skin and replace the one-piece pouch.
3. Keep the skin open to air to allow time for healing, and replace the ostomy appliance in a few days.
4. Call the health care provider to report the damaged skin.

Answer

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