A nurse is performing postoperative care for a client who is scheduled for an ileal conduit procedure. The nurse should include which of the following in the client's plan of care? (Select All that Apply.)

Choice A rationale Maintaining fluid restriction is contraindicated for a client with an ileal conduit. Adequate hydration is essential to maintain a high urine flow rate, which helps flush out mucus produced by the ileal segment used to create the conduit. Sufficient fluid intake, typically 2 to 3 liters per day unless contraindicated by cardiac issues, ensures that the stoma remains patent and reduces the risk of urinary tract infections or stone formation within the newly created urinary diversion. Choice B rationale Monitoring hourly urine output is a critical postoperative intervention to ensure the patency of the stents and the conduit. A decrease in output could indicate an obstruction, a leak at the anastomosis site, or acute kidney injury. Normal urine output should be at least 30 mL per hour. Close monitoring allows for early detection of complications such as hydronephrosis or ureteral kinking, which could lead to permanent renal damage if not addressed by the surgical team immediately. Choice C rationale Applying a skin barrier to the stoma site is vital because urine is acidic and contains enzymes that can cause rapid skin breakdown and maceration. The ileal conduit constant drainage means the peristomal skin is at high risk for chemical dermatitis. A well-fitted skin barrier protects the integrity of the epidermis, ensuring a proper seal for the drainage bag. This prevents leaking, reduces pain, and lowers the risk of secondary fungal or bacterial skin infections. Choice D rationale Hematuria is an expected finding in the immediate postoperative period following an ileal conduit procedure. The surgical manipulation of the ureters and the ileal segment, as well as the insertion of stents, causes localized trauma and capillary fragility, leading to blood-tinged urine. While the nurse should monitor for heavy bleeding or large clots, pink or red-tinted urine is normal for the first 48 to 72 hours. Education helps reduce client anxiety regarding the appearance of their urine. Choice E rationale Notifying the provider immediately for mucus in the urine is unnecessary because mucus production is a normal physiological function of the ileal segment. Since a piece of the small intestine is used to create the conduit, the goblet cells within that tissue continue to secrete mucus just as they did when part of the bowel. Patients should be taught that mucus is expected and that increasing fluid intake helps to thin the secretions so they do not clog the stoma.