For a patient with an ileal conduit urinary diversion, which nursing actions are important regarding stoma care and urinary output?

• A. Change the appliance weekly regardless of output.
• B. Assess stoma color and output, ensure proper appliance fit, and monitor for skin breakdown around the stoma.
• C. Restrict fluids to reduce output.
• D. Ignore skin around stoma unless irritation occurs.

Answer: (B)

Focusing on stoma viability, continuous urine output, and protecting the surrounding skin is essential in an ileal conduit. The stoma’s appearance reflects blood supply and function; a healthy stoma is pink to red and moist, while color changes such as dusky, pale, or black can indicate compromised blood flow or obstruction and require prompt assessment. Urine output should be monitored and documented because the conduit provides a continuous flow, so ensuring adequate hydration and watching for any sudden changes or signs of obstruction helps protect kidney function. The appliance must fit properly around the stoma to prevent leakage onto the skin, which, in turn, protects the peristomal area from irritation and breakdown. Regular inspection of the skin around the stoma for redness, irritation, or breakdown is key, and applying appropriate barrier products and skin protection supports skin integrity.

These actions collectively prevent complications and promote function of the diversion. Restricting fluids or ignoring the skin around the stoma can lead to dehydration or unmanaged skin injury, and changing the appliance without considering output or leakage can increase the risk of skin damage.