Class 7 - Ostomies Flashcards
what is an ostomy
it is a surgical procedure to divert wastes from the body
what is a stoma
the opening created surgically in the abdominal wall for an ostomy
what is a colostomy
and excretory opening in the colon (large bowel)
what is an ileostomy
an excretory opening in the ileum (small bowel)
what is a urostomy
an excretory opening that redirects urine away from the bladder.
what factors are used to choose a stoma site
- location of rectus muscle
- type of ostomy
- adequate adhesive surface
- avoid skin folds, scars, beltline, – umbilicus & bony
prominence - visibility to patient
- supportive devices present
what would cause the need for a colostomy
- trauma to small/large intestine
- diverticular disease
- obstruction
- cancer
there are 5 sites for colostomies, where are the sites
all are along the large intestine
- cecum
- ascending colon
- transverse colon
- descending colon
- sigmoid
what are the characteristics of an healthy stoma
- color should be red
- location of lumen is on the top of the stoma
- location on body is on a smooth surface
- level of protrusion 2.5 cm
- shape of stoma should be round
what skin considerations should you be aware of
- stool contains enzymes and is caustic to the skin
- essential to have all peri-stomal skin protected and a well
fitting appliance - consider the use of an “extended wear” appliance that is
more resistant to ileostomy type drainage. - ileostomies will require a “drainable” system that will
allow for frequent emptying
under what circumstances would you use a cutaneous ureterostomy
- ureteral damage or stricture from distal obstruction
- palliative treatment
- pouching challenges as ostomy is flush & small in
diameter
for a ileostomy what is the output, color and consistency
output - 500-700mLs/daily
color - varying shades of brown
consistency - paste like
for a colostomy what is the output, color and consistency
output - 1-3 formed stools daily
color - varying shades of brown
consistency - semi-formed to
formed
for a ileal conduit what is the output, color and consistency
output - wide range, usually btw
1000-2000mLs/daily
color - yellow with mucous shreds
consistency - liquid
what types of things will the patient need to be taught when having an ostomy
- stoma characteristics & function
- self care ( emptying &/appliance change)
- skin care
- diet & fluids
- lifestyle issues
- other( specific to type of ostomy)
- best time to of day to change appliance