Susie appears in the clinic with an ileostomy and changes he…

Susie appears in the clinic with an ileostomy and changes her pouch every 7 days although recently she has experienced inconsistent  pouch  wear  time  due  to  leakage. Her  stoma protrudes, is  1 ¼” round  and  has erythema and denudation from 6 o’clock to 9 o’clock. Her abdomen is flat and firm, so you do not believe convexity is needed. Her pouch has an extended wear skin barrier and is  the correct  size.  She recently began playing tennis daily  in competitions. Your recommendation is:

You are consulted to see Peggy who is on hospice and has an…

You are consulted to see Peggy who is on hospice and has an ileostomy  Due to ascites her abdomen is distended and firm with a small retraction in the peristomal field.  Her stoma is flush. She reports the pouch leaks by the second day. Which of the following interventions is MOST appropriate?