Chapter 88 Flashcards
Occurs when a portion or all the ileum or bowel is removed creating the need for an artificial opening for bowel elimination?
Bowel diversion / or fecal diversion
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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?
Stoma/ or ostomy
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A person with a ostomy of any type is referred as a ?
Ostomate
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A ____ is an opening into the colon where as a ____ is an opening into the ileum?
- Colostomy
- ileostomy
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How many stoma’s may be an end?
one stoma
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What is two stoma’s called when both cut ends of the intestine are brought to the outside?
Double barreled
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The bowel is not completely severed so the one stoma has two openings is called a?
Loop
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How should the new stoma ( mucous membrane) be kept?
Moist
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The stoma ( mucous membrane) ranges in what colors and how does it look?
- Dark red to Rich pink
- Pursed lips
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The removal of only a small amount of bowel?
Wedge resection
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Removal of a larger portion of the bowel?
Bowel Resection
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The colostomy or ileostomy will be permanent if the __ or ___ is removed completely?
Colon or Rectum
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Usually made at the level of the descending or sigmoid colon, and located on the left side of abdomen?
Permanent Colostomy
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Entire large intestine has been removed located on lower right side of abdomen?
ileostomy
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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?
Colostomy irrigation
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How full should you let the colostomy or ileostomy get with stool or gas before emptying?
1/3 or half full
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What two things needs to be removed regularly, emptied, rinsed and replaced over the stoma 1 to 2 times per week?
Face plate and pouch
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The pouch opening should be about ___ larger than the stoma size to prevent skin irritation?
2mm
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How long should you hold down to help seal the new appliance?
2 minutes
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Observe the new stoma every ______ ?
6 - 12 hours
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After ____ the nurse can fit the client into a pre-cut appliance?
4 - 6 weeks
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To prevent a hernia heavy lifting is prohibited for ____ weeks and no heavier than ___ ?
- 6 - 8 weeks
- 5 lbs
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What kind of diet and for how long should the client follow after any bowel surgery?
- low - fiber diet
- 1 month
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ileostomy needs to monitor diet more closely due to the most common complication?
Food blockage
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Foods that cause blockage with an ileostomy?
Dried fruits, popcorn, many vegetables, and nuts, meats in casings like frankfurters.
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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.
ileostomy patient
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Which is more irritating on the skin an ileal drainage or a colostomy drainage?
ileal drainage
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The client may have concerns about how life might be disrupted what concerns might this be?
Sexual relations, care of colostomy/ ileostomy, and acceptance from family and friends.
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Surgical creation of a colon - like pouch fashioned from the small intestine that collects drainage.
ileoanal reservoir
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ileoanal reservoir is also known as a?
pelvic pouch or J - pouch
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What is the first stage of the ileoanal reservoir procedure?
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.
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What is the second stage of ileoanal reservoir procedure?
Surgical take down of the ileostomy the reservoir acts as a the sigmoid colon and client usually achieves control of bowel movements.
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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?
4 to 8 times
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This procedure is usually impossible if the client is obese, high risk, Crohn disease, toxic megacolon, diabetes mellitus, or active colitis.
Kock pouch or Continent ileostomy
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Kock procedure removes?
colon, rectum, and anus
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Nursing care of the Kock pouch or continent ileostomy is?
Catheterizing the pouch and irrigating it with 20 - 50mL of normal saline every 2 hours.
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procedure necessary for diagnostic purposes to relieve ascites ( fluid accumulation) for culturing and bleeding and infection is suspected?
abdominal Paracentesis ( abdominal tap)
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This is done when the client is distended with ascitic fluid?
Therapeutic abdominal tap
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