# A patient post-radical cystectomy with ileal conduit urinary diversion is being taught urostomy self-care. Which teaching points are appropriate? Select all that apply.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374924&lang=en  
> language: en  
> subject: Pharmacological and Parenteral Therapies  
> category: PPT

## Question

A patient post-radical cystectomy with ileal conduit urinary diversion is being taught urostomy self-care. Which teaching points are appropriate? Select all that apply.

1

Restrict fluid intake to less than 1000 mL per day to reduce urine volume and limit pouch emptying, thereby preventing peristomal skin breakdown.

2

Encourage 2000 to 3000 mL of fluid per day (unless contraindicated) to flush the conduit, reduce mucus thickening, and prevent stone formation and infection.

3

Mucus in the urine is NORMAL because the conduit is made from intestine which secretes mucus; this does not indicate infection.

4

Empty the urostomy pouch when 1/3 to 1/2 full to prevent leakage and skin breakdown; change the appliance every 3 to 7 days or as needed.

5

A healthy stoma is beefy red, moist, and protrudes 1-3 cm; report any dusky, pale, dark purple, or black coloration to the provider immediately as it suggests poor perfusion or necrosis.

## Explanation

Ileal conduit teaching: healthy stoma beefy red (notify for dusky/pale/dark color), mucus in urine is normal (intestine origin), empty pouch at 1/3 to 1/2, change every 3-7 days, and encourage 2000-3000 mL fluids daily for conduit flushing. Choice 1 is wrong — fluid restriction increases urine concentration, mucus thickening, stone formation, and infection risk; the opposite is recommended.

## In-depth explanation

Two ileal conduit traps: (1) "mucus in urine = infection" — wrong, mucus is normal because the conduit is intestine; (2) "restrict fluids to reduce output" — wrong, encourage 2-3 L/day to flush. Stoma color changes (dusky, pale, dark purple, black) require STAT provider notification because they suggest stoma necrosis from compromised perfusion.

## Clinical scenario

Patient **post-radical cystectomy with ileal conduit urinary diversion** for bladder cancer; ready for urostomy self-care teaching. Stoma is beefy red, slightly edematous, and continuously draining clear urine with mucus.

## Key concepts

- **Ileal conduit** — Urinary diversion using a section of ileum to channel urine to a stoma after cystectomy; mucus in urine is normal.
- **Healthy stoma assessment** — Beefy red, moist, protrudes 1-3 cm; dusky/pale/dark purple/black requires STAT notification (necrosis risk).
- **Conduit fluid teaching** — 2000-3000 mL/day flushes the conduit, reduces mucus thickening, and prevents stones and infection.

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