GIT - Stomas Flashcards
1
Q
Ostomy Surgery
A
- procedure where a permanent opening through to the surface of the abdomen is made
- bowel is brought to the opening onto the surface, faecal matter emptied into collection bag
- colostomy - colon
- ilestomy - ileum
2
Q
Types of Surgery
A
- end stoma
- loop stoma
- double barrell stoma
- kock pouch
- ileoanal reservior
3
Q
Bowel Diversion - Stools
A
- ilesotomy
- formed from ileum in small intestine, discharge from stoma is usually liquid or pasty in consistency and occurs several times a day, usually after meals, not physically able to be controlled
- colostomy
- ascending colostomy - right side of abdomen, stool is liquid - semi-liquid, rich in digestive enzymes & discharge is irritating to skin around stoma
- transverse colostomy - middle of abdomen, stool is liquid - semi-formed, usually less irritating to surrounding skin
- descending colostomy - left side of abdomen, stool is semi-formed - formed as most of the water has been absorbed as it moves through ascending & transverse sections of the colon
- sigmoid colostomy - lower left side of the abdomen, stool has a normal, formed consistency
4
Q
Pre-Operative care
A
- education
- siting of colostomy
- stomal therapy nurse involvement
- expected pain relief measures
- bowel preparation measures & oral / parenteral antibiotics to reduce risk of peritoneal confamination
5
Q
Nursing Management
A
- knowledge defecit - educate about what’s happening, what they can excpect, when to change bag, what they can / can’t eat, referral to stomal nurse, family & partner education, correct sizing of bags
- body image - body image disturbance, altered sexuality patterns due to stoma, anticipatory grieving due to loss of bowel / cancer, impaired social interactions due to fear of odour & seepage
- anxiety
- skin problems
- nutritional problems
- fluid and electrolyte imbalance
- sexuality dysfunction
6
Q
Post-Operative Care
A
- nil orally till bowel sounds evident
- IV fluids
- NG tube for gastric decompression
- physical discomfort - surgeical opening, specific examples?
- psychological implications