Chapter 88

Question 1

Occurs when a portion or all the ileum or bowel is removed creating the need for an artificial opening for bowel elimination?

Answer 1

Bowel diversion / or fecal diversion
p. 1595

Question 2

An incision is made in the abdomen and a loop of intestine is brought through the incision and opened to allow drainage of feces is called?

Answer 2

Stoma/ or ostomy
p. 1595

Question 3

A person with a ostomy of any type is referred as a ?

Answer 3

Ostomate
p. 1595

Question 4

A ____ is an opening into the colon where as a ____ is an opening into the ileum?

Answer 4

1. Colostomy
2. ileostomy
   p. 1595

Question 5

How many stoma’s may be an end?

Answer 5

one stoma
p. 1595

Question 6

What is two stoma’s called when both cut ends of the intestine are brought to the outside?

Answer 6

Double barreled
p. 1595

Question 7

The bowel is not completely severed so the one stoma has two openings is called a?

Answer 7

Loop
p. 1595

Question 8

How should the new stoma ( mucous membrane) be kept?

Answer 8

Moist
p. 1595

Question 9

The stoma ( mucous membrane) ranges in what colors and how does it look?

Answer 9

1. Dark red to Rich pink
2. Pursed lips
   p. 1595

Question 10

The removal of only a small amount of bowel?

Answer 10

Wedge resection
p. 1595

Question 11

Removal of a larger portion of the bowel?

Answer 11

Bowel Resection
p. 1595

Question 12

The colostomy or ileostomy will be permanent if the __ or ___ is removed completely?

Answer 12

Colon or Rectum
p. 1596

Question 13

Usually made at the level of the descending or sigmoid colon, and located on the left side of abdomen?

Answer 13

Permanent Colostomy
p. 1596

Question 14

Entire large intestine has been removed located on lower right side of abdomen?

Answer 14

ileostomy
p.1596

Question 15

Client does not learn this until at least 6 weeks after surgery to allow healing. Very time consuming of about 1 - 1.5 Hours to complete?

Answer 15

Colostomy irrigation
p. 1596

Question 16

How full should you let the colostomy or ileostomy get with stool or gas before emptying?

Answer 16

1/3 or half full
p. 1596

Question 17

What two things needs to be removed regularly, emptied, rinsed and replaced over the stoma 1 to 2 times per week?

Answer 17

Face plate and pouch
p. 1596

Question 18

The pouch opening should be about ___ larger than the stoma size to prevent skin irritation?

Answer 18

2mm
p. 1596 88-2 box

Question 19

How long should you hold down to help seal the new appliance?

Answer 19

2 minutes
p. 1596 88-2 Box

Question 20

Observe the new stoma every ______ ?

Answer 20

6 - 12 hours
p. 1596 88-2 Box

Question 21

After ____ the nurse can fit the client into a pre-cut appliance?

Answer 21

4 - 6 weeks
p. 1596

Question 22

To prevent a hernia heavy lifting is prohibited for ____ weeks and no heavier than ___ ?

Answer 22

1. 6 - 8 weeks
2. 5 lbs
   p. 1596

Question 23

What kind of diet and for how long should the client follow after any bowel surgery?

Answer 23

1. low - fiber diet
2. 1 month
   p.1597

Question 24

ileostomy needs to monitor diet more closely due to the most common complication?

Answer 24

Food blockage
p. 1597

Question 25

Foods that cause blockage with an ileostomy?

Answer 25

Dried fruits, popcorn, many vegetables, and nuts, meats in casings like frankfurters.
p. 1597

Question 26

Which person needs more fluids due to loss fluids in elimination because less formed stools and sodium and potassium. They also need not just water but electrolytes also.

Answer 26

ileostomy patient
p. 1597

Question 27

Which is more irritating on the skin an ileal drainage or a colostomy drainage?

Answer 27

ileal drainage
p. 1597

Question 28

The client may have concerns about how life might be disrupted what concerns might this be?

Answer 28

Sexual relations, care of colostomy/ ileostomy, and acceptance from family and friends.
p. 1597

Question 29

Surgical creation of a colon - like pouch fashioned from the small intestine that collects drainage.

Answer 29

ileoanal reservoir
p. 1598

Question 30

ileoanal reservoir is also known as a?

Answer 30

pelvic pouch or J - pouch
p. 1598

Question 31

What is the first stage of the ileoanal reservoir procedure?

Answer 31

Entire colon and lining of rectum is removed and reservoir is fashioned. Anal sphincter is retained and pouch is sewn to it. And client eliminates stool into the ileostomy stoma for 6 weeks to 3 months while resting the bowel.
p. 1598

Question 32

What is the second stage of ileoanal reservoir procedure?

Answer 32

Surgical take down of the ileostomy the reservoir acts as a the sigmoid colon and client usually achieves control of bowel movements.
p. 1598

Question 33

The ileoanal takes a longer recovery time but improves quality of life for the client by making them pass stool _ to _ in 24 hours without a permanent stoma?

Answer 33

4 to 8 times
p. 1598

Question 34

This procedure is usually impossible if the client is obese, high risk, Crohn disease, toxic megacolon, diabetes mellitus, or active colitis.

Answer 34

Kock pouch or Continent ileostomy
p. 1599

Question 35

Kock procedure removes?

Answer 35

colon, rectum, and anus
p. 1599

Question 36

Nursing care of the Kock pouch or continent ileostomy is?

Answer 36

Catheterizing the pouch and irrigating it with 20 - 50mL of normal saline every 2 hours.
p. 1599

Question 37

procedure necessary for diagnostic purposes to relieve ascites ( fluid accumulation) for culturing and bleeding and infection is suspected?

Answer 37

abdominal Paracentesis ( abdominal tap)
p. 1599

Question 38

This is done when the client is distended with ascitic fluid?

Answer 38

Therapeutic abdominal tap
p. 1599