Which item is specifically noted as requiring a higher plane for a urostomy during site marking?

• A. Pendulous breasts
• B. Hernias
• C. Braces or devices worn by patient
• D. Presence of other stomas (urostomy should be higher plane if possible)

Answer: (D)

When marking a site for a urostomy in someone with another stoma, placing the urostomy on a higher plane helps keep the two appliances separate and prevents crowding. This separation makes pouch changes easier, reduces the risk of one appliance interfering with the other, and lowers the chance of urine from the urostomy affecting the skin near the other stoma or causing appliance seal problems. It also accommodates clothing and belt positioning so neither appliance is compressed or pulled.

Other factors like pendulous breasts, hernias, or braces can influence exact placement for comfort and contour, but they don’t specifically require a higher plane due to the presence of another stoma.