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
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2
Q

Types of Surgery

A
  • end stoma
  • loop stoma
  • double barrell stoma
  • kock pouch
  • ileoanal reservior
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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
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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
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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
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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
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