A patient receiving PN with high ileostomy output should have which PN change?

• A. Decrease water and decrease sodium
• B. Increase sodium and increase fluid volume
• C. Decrease sodium and increase protein
• D. Increase sodium and decrease protein

Answer: (B)

High ileostomy output means you’re losing a lot of fluid and electrolytes, especially sodium, through the stoma. When a patient relies on parenteral nutrition, those ongoing losses must be replaced in the PN to maintain circulating volume and electrolyte balance. Replacing the sodium lost in the output helps prevent hyponatremia and dehydration, while increasing the overall fluid volume in the PN supports intravascular volume and urine output. Protein is important for nutrition, but it doesn’t address the volume and electrolyte losses driving instability. So, increasing both sodium and fluid in the PN best corrects the imbalance caused by high ileostomy output.