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Med Surg II > Exam 1: Ostomies > Flashcards

Exam 1: Ostomies Flashcards

1
Q

What is an Ileostomy ?

A

The colon, rectum, and part of the ileum have been removed, and the rest of the Ileum Is brought out through the abdomen

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2
Q

Ileum = ?

A

End of the small intestine

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3
Q

An ileostomy will most likely have what type of output ?

A

Liquidy

  • b/c a lot of water absorption occurs in the Large Intestine
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4
Q

Ilieostomies are most common in what health problems ?

A
  • UC
  • Crohn’s
  • Familial Polyps
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5
Q

What do we want to encourage in pt’s with an Ileostomy?

A

Encourage fluid intake !!

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6
Q

True or False: Depending on where the Ostomy is located will determine how Liquidly or formed the stool is ?

A

True

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7
Q

A Colostomy is defined as what ?

A

Opening from the colon

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8
Q

A person with an colostomy in the ascending colon will have what type of output ?

A

Semi Liquid

  • Increase/encourage fluids
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9
Q

A person with a colostomy in the Transverse colon will have what type of output ?

A

Semi liquid / Semi formed

  • possibly need to increase fluids
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10
Q

A person with a colostomy in the sigmoid colon will have what type of output ?

A

Formed

  • B/c the majority of the water has been absorbed from the stool
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11
Q

True or False: Pt’s with long term ostomies, typically only have 1 ?

A

True

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12
Q

Is it true that some people won’t even look at their stoma in the hospital & thats okay! ?

A

Yes

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13
Q

True or False: We don’t want to force people to look at their stoma if their not ready ?

A

True

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14
Q

True or False: Even if the pt isn’t ready to look at their stoma in the hospital, we still need to make sure that somebody is responsible for the care post-op, whether thats a family member or friend, etc. ?

A

True

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15
Q

What does Preoperative care for an stony look like ?

A
  • Psychological preperation
  • WOCN (Wound Ostomy Care Nurse)
  • Stoma Marking
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16
Q

Who picks the stoma marking prior to surgery ?

A

The Ostomy nurse picks where the stoma will go on the patient.

  • They will talk with the pt prior and talk about clothing, daily activities, etc. to determine the best place for the stoma to be !
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17
Q

True or False: Pt’s may not consent to Preoperative Ostomy care right away, it may take some time ?

A

True

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18
Q

What general postoperative things do we want to be thinking about with an Ostomy ?

A
  • VS
  • Pain
  • Fluid status
  • Psychological and emotional support for the patient
19
Q

True or False: Edema is normal Post-op ?

A

True

20
Q

What is the normal color of the Stoma ?

A

Rosy pink to Beefy Red

21
Q

True or False: We want to protect the skin post-op, by keeping stool from eating away at the skin around the stoma ?

A

True

22
Q

True or False: We want to have a good fit with the stoma appliance postoperatively and always ?

A

True

23
Q

Generally, how much skin do we want between the stoma and the edge of the wafer ?

A

1/8 to 1/4

24
Q

True or False: We want to make the fit as tight as we can without pinching the stoma ?

A

True

25
Q

True or False: Postoperatively the area around the stoma will be very edematous, and we have to remind the pt. that the swelling will go down ?

A

True

26
Q

True or False: Postoperatively the stoma will protrude about 2cm away from the abdominal wall ?

A

True

27
Q

postoperatively the stoma is usually brick red & moist ?

A

yes

28
Q

True or False: a small amount of bleeding at the stoma is normal postoperatively ?

A

True

29
Q

With a stoma, what do we want to monitor for postoperatively ?

A

want to monitor for ischemia & necrosis of the stoma

  • we want to make sure the stoma is being perfused !
30
Q

What signs would tell us if a stoma is showing signs of ischemia & necrosis ?

A
  • Dark red, purple, black color
  • Firm
  • Flaccid
  • unusual bleeding
31
Q

What is Mucocutaneous separation ?

A

Breakdown of suture line securing the stoma to the abdominal wall

  • usually it will just need to be sutured back together
  • When in doubt call the provider or ask an experienced nurse!
32
Q

When do we typically want to empty an Ostomy?

A

When the bag is about 1/3 full

  • We don’t want it pulling away and putting pressure on the wafer and skin
33
Q

Generally we want people with Ostomies to consume how much fluid ?

A

3L

34
Q

True or False: The pt’s will need to play around with foods in the beginning ?

A

True

35
Q

True or False: In regards to Ostomy self care, initially somebody will need to do the care, and then eventually in most cases the pt. will need to learn to do it themselves ?

A

True

36
Q

True or False: WOCN’s are wonderful resource people ?

A

True

37
Q

What are effects of food on stoma output ?

A
  • Odor producing
  • Gas producing
  • Diarrhea
  • Potential obstruction in ileostomy
38
Q

What are examples of foods that are odor producing on stoma output ?

A
  • Garlic
  • Onions
  • Eggs
  • Fish
39
Q

What are examples of foods/drinks that are gas producing on stoma output ?

A
  • Beans
  • Brocoli
  • Cauliflower
  • Carbonated beverages
40
Q

What are examples of foods that may need to be avoided to reduce the risk of potential obstruction of the ileostomy ?

A
  • Nuts
  • Seeds
  • Popcorn
  • Sausage/meets with casings
41
Q

What are examples of foods that may cause Diarrhea in someone with a stoma ?

A
  • ETOH
  • Coffee
  • Spicy foods
42
Q

True or False: The ileum is more narrow than the colon ?

A

True

43
Q

What are pt. teaching points for pt’s with an Ostomy ?

A
  • Principles of stony & appliance care
  • Dietary guidelines (need to experiment w/ foods)
  • Fluid guidlines (depends on consistency of stools)
  • Resources for psychological & emotional adjustment
  • Importance of follow-up care
    - Fluid deficits
    - Fever
    - Skin irritation
    - Stoma problems
    - inversion, eversion, discoloration, abscess, or infection
44
Q

True or False: If pt’s are dehydrated they’ll most likely start with a low grade fever ? and pt’s with a low grade fever will often be treated with fluids which will help ?

A

True

Med Surg II (13 decks)

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