Bowel Elimination and Care

Question 1

Are ostomies temporary or permanent?

Answer 1

They can be both depending on the situation.
- Temporary: Created to allow the intestines to heal from surgery or disease
- Permanent: May be required when a disease affects the end part of the colon or rectum

Question 2

During an ostomy bag change, position the patient so that there are no _____ occur along the line of the stoma.

Answer 2

skinfolds

Question 3

To calculate, the amount of output in mL for an ostomy with liquid effluent (i.e. ileostomy or urostomy), what type of container should you use?

Answer 3

Graduated measuring container

Question 4

Are all ostomy pouches drainable?

Answer 4

No. Drainable (open-ended) pouches that have either a clamp, press & seal, or velcro attachment. Closed (one-time use, disposable) pouches must be removed and disposed of once full.

Question 5

It important to place a protective/moisture-proof pad to protect the patient and any linens prior to checking the ostomy bag. TRUE or FALSE.

Answer 5

TRUE

Question 6

If the stoma is purple-black in color what does it indicate?

Answer 6

Purple-black coloration indicates compromised circulation, and it requires immediate surgeon/physician notification.

Question 7

When removing the ostomy bag and wafer from the pt’s skin, it is important to use a _____-based adhesive remover.

Answer 7

silicone.

Question 8

How would you remove the ostomy bag and wafer? And in what direction?

Answer 8

• With one hand, apply the silicone-based adhesive remover as you press the skin away from the wafer barrier with your other hand. - - Begin at the top and work downward.

Question 9

Inspect the stoma and peristomal skin area for what?

Answer 9

• Stoma size
• Color changes (stoma should be red/pink)
• Rash
• Irritation
• Excoriation

Question 10

What would you use to cleanse the stoma and peristomal (surrounding skin) area?

Answer 10

Gently wash w/ a cleansing agent (pH of 5.5; designed to cleanse and moisturize the skin) and warm water

Question 11

How can you measure the size of the stoma?

Answer 11

• Standard stoma measuring guide
• Reuse a previously cut stoma template
• Measure the stoma from side to side to approx. the circumference

Question 12

After removing the ostomy bag, cleansing the stoma and peristomal skin, what should you place over the stoma while you prepare the new bag?

Answer 12

Clean gauze 4 x 4

Question 13

The opening of the wafer should be exactly the stoma’s circumference. TRUE or FALSE.

Answer 13

The wafer opening should be approx. 1/16 to 1/8-inch larger than the stoma’s circumference– to allow for stoma changes (size and shape) d/t to factors including weight gain/loss.

Question 14

What happens if the ostomy wafer opening is too big?

Answer 14

It can expose the skin to output (risk for skin breakdown)

Question 15

What happens if the ostomy wafer opening is too small?

Answer 15

The wafter can rub against the stoma (stoma can be irritated)

Question 16

How do you warm the adhesive ring of an ostomy wafer?

Answer 16

Hold btwn the palms of your hands

Question 17

Prior to applying the new ostomy wafer and bag, what should you apply to the skin?

Answer 17

Ostomy skin care products per hospital protocol:
- Skin prep
- Skin barrier powder
- Skin barrier paste (brand Karaya)

Question 18

How should the ostomy bag be positioned?

Answer 18

The ostomy bag is pointed towards the pt’s ft

Question 19

Describe the stool consistency that you would expected from an ascending colostomy, transverse colostomy, descending colostomy and sigmoid colostomy.

Answer 19

• Ascending: Liquid
• Transverse: Loose to semi-formed
• Descending and Sigmoid: near-normal

Question 20

Post-operatively how would the stool of a pt with a colostomy look like/progress?

Answer 20

Post-operatively, it will be liquid but will become more solid, depending on the area of the colostomy