ATI SKILLS- OSTOMY CARE

Question 1

OSTOMY

Answer 1

SURGICALLY CREATED OPENING IN THE ABDOMINAL WALL TO ALLOW FOR THE ELIMINATION OF URINE OR FECES

Question 2

INDICATIONS FOR AN OSTOMY SURGERY

Answer 2

1. CONGENITAL ANOMALIES
2. BLADDER, COLON, AND RECTAL CANCER
3. IBD (CROHNS DISEASE, ULCERATIVE COLITIS)
4. INHERITED DISORDERS
5. OBSTRUCTION OF THE URETER
6. STAB/GUNSHOT WOUND TO THE ABDOMEN

Question 3

3 TYPES OF OSTOMY SUGERY

Answer 3

COLOSTOMY
ILEOSTOMY
UROSTOMY

Question 4

STOMA

Answer 4

SURGICALLY CREATED OPENING IN THE SKIN OF THE ABDOMEN

THE COMMUNICATING END BROUGHT THROUGH THE SKIN

Question 5

THE LOCATION OF THE STOMA DEPENDS ON WHAT

Answer 5

1. LOCATION OF BELT LINE
2. ANY SCARS/SKIN FOLDS
3. WHERE THE DAMAGE IS
4. TYPE OF OSTOMY PERFORMED

Question 6

WHAT SHOULD A STOMA LOOK LIKE

Answer 6

SHINY, MOIST, RED, SIMILAR TO THE MUCOUS MEMBRANES OF THE MOUTH, ROUND OR OVAL, PROTRUDING, FLUSH OR RETRACTED

Question 7

COLOSTOMY

Answer 7

CREATED FROM THE END OF THE LARGE INTESTINE TO DIVERT WASTE FROM THE DIGESTIVE SYSTEM

Question 8

3 TYPES OF COLOSTOMY

Answer 8

END COLOSTOMY
LOOP COLOSTOMY
DOUBLE BARREL COLOSTOMY

Question 9

END COLOSTOMY

Answer 9

DAMAGED SECTION IS REMOVED, WORKING END IS BROUGH THROUGH THE ABDOMEN
USUALLY USED WHEN IT IS MEANT TO BE PERMANENT

Question 10

WHEN MAY A TEMPORARY COLOSTOMY BE PERFORMED

Answer 10

TO ALLOW FOR BOWEL REST/HEALING SUCH AS FOLLOWING TUMOR RESECTION

Question 11

HARTMANN’S POUCH

Answer 11

WHAT IS CREATED WITH A TEMPORARY COLOSTOMY SURGERY WHERE THE DISTAL PORTION IS LEFT IN PLACE AND OVERSOWN FOR CLOSURE

Question 12

ANASTOMOSIS

Answer 12

surgical connection between 2 structures. it most often means a connection that is created between tubular structures, such as blood vessels or loops of intestine

Question 13

what happens in a loop colostomy

Answer 13

a loop of the bowel is brought through the abdomen to the skin surface and temporarily supported by a plastic bridge or rod

Question 14

when would a transverse loop colostomy created

Answer 14

as an emergency procedure to relieve an intestinal obstruction or perforation

Question 15

how is the stoma in a loop colostomy different from others

Answer 15

1. 2 openings through one stoma (proximal drains stool and distal drains mucus)
2. bridge can be removed in 7-10 days
3. typically temporary

Question 16

explain the stoma(s) in a double barrel colostomy

Answer 16

2 seperate stomas are brought through the abdomen in 2 different places. the distal colon is usually just bypassed. the proximal stoma is functional and diverts feces to the abdominal wall

Question 17

distal stoma of a double barrel colostomy

Answer 17

aka mucous fistula
expels mucus from the distal colon

Question 18

ascending colon (right abdomen)

stoma location

Answer 18

output is typically liquid to semi liquid and very irritating to surrounding skin

Question 19

transverse colon (mid abdomen)

stoma location

Answer 19

used for temporary ostomy
stoma constructed as a loop
output is pasty

Question 20

descending colon
left upper abdomen

stoma location

Answer 20

output is semi formed because more water is absorbed while fecal material is in the ascending and transverse colon

Question 21

sigmoid colon
left lower abdomen

stoma location

Answer 21

location for a permanent colostomy
particularly for cancer of the rectum
typically located on the lower left quadrant of the abdomen and the output is formed

Question 22

foods that MAY have to be avoided after a colostomy

Answer 22

chocolate, dried beans, fried foods, highly spiced foods, raw fruits/vegetables, and even antibiotics

Question 23

foods that may cause a blockage with a colostomy

Answer 23

stringy vegetables, coconut, coleslaw, mushrooms, popcorn, seeds, berries, celery, fresh tomatoes

Question 24

if a colostomy patient is having large amounts of effluent, what should we suggest

Answer 24

limit insoluble fiber intake to decrease time required for food digestion. some may have to add foods that thicken stool like applesauce, bananas, cheese, pasta, and rice

Question 25

clients can prevent the passage of malodorous flatus by avoiding foods that cause odors such as

Answer 25

asparagus, beans, cabbage, eggs, fish, garlic, onions, some spices

Question 26

why should colostomy patients use caution when using laxatives and enenmas

Answer 26

potential for fluid and electrolyte imbalance. should also use caution with enteric coated and sustained release meds.

Question 27

ileostomy

Answer 27

surgical opening created in the ileum to bypass the entire large intestine

Question 28

stoma of an ileostomy is typically located

Answer 28

right lower quadrant

Question 29

a restorative proctocolectomy with ileal pouch anal anastomosis (ipaa) involves

Answer 29

connecting the ileum to a new rectum (anal pouch) also made out of a portion of ileum

Question 30

when is ipaa procedure of choice

Answer 30

where rectum can be preserved. allows the client to retain anal sphincter control of bm. will have a temporary loop ileostomy while the pouch heals

Question 31

kock’s continent ileostomy

Answer 31

internal pouch is created from the distal segment of the ileum which serves as a reservoir for stool. a one way nipple valve is constructed through the stoma so client can insert catheter and drain contents

Question 32

clients who have an ileostomy are at a higher risk of what

Answer 32

fluid and electrolyte imbalances due to shorter transit time through the bowel, decreased absorption of fluid/nutrients, and higher volume of effluent. Na and K can be depleted quickly. prevention requires at least 80-96 ounces of h2o daily

Question 33

when ileostomy is new, what are some special considerations

Answer 33

1. chew thoroughly– narrow ileum
2. avoid high fiber foods for first 6-8 weeks
3. avoid foods causing intestinal gas
4. caution with enteric coated meds

Question 34

drainage from an ileostomy is typically

Answer 34

dark green, loose, odorless

Question 35

when to empty ileostomy pouch

Answer 35

1/3-1/2 full
may require several times a day
contains enzymes and bile salts that can irritate the skin

Question 36

skin barrier

Answer 36

protective artificial layer placed over skin to protect it and help maintain skin integrity

Question 37

common manifestations of food blockage to be aware of

Answer 37

cramping, n&v, stoma swelling, no output for 6+ hours. will need to lie down in a knee-chest position to releive pressure and massage to promote peristalsis and fecal elimination

Question 38

urostomy

Answer 38

urinary diversion that allows urine to exit the body after removal of a diseased or damaged section of the urinary tract

Question 39

ileal conduit

Answer 39

isolated segment of ileum that serves as a substitution for the bladder. ureters are implanted and the lumen is connected to the skin