Exam 3 - Colorectal Cancer and colostomies/ileostomies

Question 1

Manifestations of colorectal cancer

Answer 1

Can be asymptomatic for 5-15 years as disease progresses.
Sudden change in bowel habits and/or stool consistency (earlier sign)
Rectal bleeding
Persistent abd pain such as cramps or gas
Anemia
Weight loss
Anorexia and unexplained weight loss (late sign)

Question 2

What is an enterostomal therapist?

Answer 2

For marking and teaching about the stoma location, ostomy care, options for ostomy appliances.

Question 3

Who should you refer a pt to for a new ostomy?

Answer 3

Local United Ostomy Association

Question 4

Pre-operative bowel preparation

Answer 4

Cathartics, enemas, pre-op antibiotics to reduce abd contamination and infection after surgery

Question 5

When is an NG tube inserted?

Answer 5

Just prior to surgery. Used to remove secretions, empty stomach contents, decompress stomach and keep bowel rested

Question 6

Assessment post-surgery for colostomy

Answer 6

Assess color of stoma
Maintain NG suction
Monitor resp status
Monitor response to diet, presence of bowel sounds
Assess for abd distention, bowel obstruction
Monitor for rectal bleeding
Monitor for paralytic ileus, obstruction, peritonitis, abscess formation, infection, wound disruption, wound infection, presence of fistula