مريض عمل فتحة لفائفية (إليوستومي) قبل أسبوع، خرج للبيت ورجع بدوخة وعطش وقلة بول. يقول إن الكيس يمتلئ بسائل مائي كثير وأفرغه أكثر من ١٠ مرات اليوم. الضغط ٩٤/٦٠، النبض ١١٦، الكرياتينين ارتفع. ما المشكلة الأساسية؟

A client with a new ileostomy is readmitted a week after discharge with dizziness, thirst and low urine output. He says the pouch fills with watery output and he has emptied it over 10 times today. BP 94/60, HR 116, creatinine has risen. What is the main problem?

1. A wound infection needing antibiotics
2. Stoma blockage from eating fibre
3. Dehydration and electrolyte loss from high output
4. Internal bleeding from the surgical site into the abdomen

Answer: C) Dehydration and electrolyte loss from high output. Ileostomy output is normally liquid, but high output (over 1.5–2 L) causes dehydration, low sodium and potassium, and kidney injury. Treat with IV fluids and electrolytes, oral rehydration solution and antimotility drugs.