ileostomy output

[blackribbon]

I had a patient this week with what is supposed to be an ileostomy. She was in for abdominal pain around the area of her stoma radiating to her back and was c.diff positive. The main nursing activity was controlling the pain, caring for a pressure ulcer on her iliac crest, and trying to get the output to stop being so watery??? When I got her, I was handed off that they were happy the output was starting to become "formed again" (it is hard to describe what it looked like but yeah, it was getting some texture to it). Isn't ileostomy output supposed to be watery? I had her for two nights and neither day shift nurse could tell me why we wanted "formed" stool in her bag. I finally went in the last day and asked the patient if she had an ileostomy or a coloscopy ... and she replied that she used to have a coloscopy but in January, changed it to a ileostomy. But nobody had educated her on the difference in outputs either..and she wasn't really sure of what the goal was either. I told her I was going to learn more about the differences on my days off but she should ask the ostomy nurse what she should be expect her output to look like.

Also, this patient was great and after I did her dressing change and we had discussed ileostomies vs coloscopyies, I asked if she would allow me to listen to her bowel sounds all over her abdomen because I was tired of looking at prior shifts charting "bowel sound x4"...she only had part of a colon so I know they weren't really hearing BSx4..and I discovered that yes, she had sound in all four quadrants where you would expect them but I also heard them near her naval and just above her public area ... in other words, you could hear sounds everywhere. It was kind of cool but since she didn't have a whole colon, BSx4 was not proper charting. We chart in Epic...how would you chart small bowel sounds?