Lab 6 Ostomy-Rectal Meds-Enemas-Rectal Tubes

Question 1

how full should an ostomy pouch be before you change it

Answer 1

empty when 1/3 full

Question 2

how often is an ostomy pouch changed

Answer 2

depends on pouch but usually every 3-5 days

Question 3

when is the best time to change an ostomy pouch

Answer 3

either before breakfast or 1-2 hours after

Question 4

what type of drainage would a colostomy have

Answer 4

semi formed to mostly formed stool since most of the intestine remains intact so stool still forms

Question 5

what dietary changes need to be made for a person with a colostomy

Answer 5

usually people do not need to make major changes since most of the intestine remains intact

Question 6

what type of drainage would there be from an ileostomy

Answer 6

less formed liquid stool since more of the intestine has been bypassed or removed

Question 7

what are two nursing care priorities for someone who has an ileostomy

Answer 7

-assessment of intake output and fluid/electrolyte balance
-assessment of stoma skin and surrounding area since stool from an ileostomy is incredibly irritating to the skin

Question 8

would a person with an ileostomy require more fluids than a person with a colostomy

Answer 8

yes since the more intestine you have removed the more fluids are lost since there is less time for absorption

Question 9

What is the most common type of urostomy

Answer 9

ileal conduit which is where a piece of ilium is taken to create a stoma for the urinary system

Question 10

how often is a urostomy pouch changed

Answer 10

every 2-7 days

Question 11

does a bowel resection always result in the formation of an ostomy

Answer 11

no since they can sometimes perform anastomosis which is when the rejoin the two ends of the bowel

Question 12

What is a hartmann’s procedure

Answer 12

when there is a part of bowel left in place beyond the stoma so it may be reversed at a later time

Question 13

what is a loop ostomy

Answer 13

bowel is not completely severed and instead a loop of bowel is brought through the skin

Question 14

what is a double barrel stoma

Answer 14

when the bowel is cut into to sections and both sections are brought to the surface

Question 15

What is the biggestconcern when a PT has a stoma prolapse

Answer 15

May compromise the circulation of the stoma

Question 16

what is mucocutaneous separation

Answer 16

when the stoma starts to become detached from the skin that surrounds it

Question 17

what is the difference between contact dermatitis and irritant dermatitis

Answer 17

Contact dermatitis is when the PT is sensitive to a product used in the ostomy system like tape or powder and irritant dermatitis is when the skin has become irritated from the contents of the ostomy bag

Question 18

What device is used right after an ostomy surgery to ensure that caregivers don’t have to press to hard on the skin

Answer 18

A low pressure adapter which gives the clinician more finger space so they don’t have to press to hard on the patient

Question 19

what type of ostomy would a closed end pouch be used

Answer 19

usually used for a colostomy since the PT is probably producing fully formed stool and it might only happen once a day

Question 20

what product would a nurse use if they wanted to keep skin dry and keep the pouching system well adhered to the skin

Answer 20

stomahesive powder

Question 21

What products can be used to fill gaps around the bag and protect the skin of the patient

Answer 21

Stoma paste and barrier rings/strips

Question 22

What is the goal of ostomy irrigation

Answer 22

The goal is to train the bowel to empty at the same time each day

Question 23

What are two important medication considerations to make for a patient with an ileostomy

Answer 23

-Avoid enteric coated tablets and extended release medication (since they won’t have time to absorb the medication without the large intestine)
-may be helpful to take liquid medications or crush tablets to increase absorption

Question 23

What is the goal of a cleansing enema

Answer 23

used to promote complete evacuation by stimulating peristalsis with large volume of fluid

Question 24

what is the goal of a carminative enema

Answer 24

to stimulate peristalsis and expel flatus

Question 25

what is the goal of an oil retention enema

Answer 25

Lubricates the rectum and the feces absorbs the oil which softens the stool

Question 26

what suppository would be used to soften the stool

Answer 26

glycerin suppository since it draws more water into the intestine to make the stool softer

Question 27

What suppository would be used to stimulate more peristalsis to produce a bowel movement

Answer 27

bisacodyl suppository

Question 28

what medications would a patient on level 1 bowel protocol receive

Answer 28

they would receive sennosides 12 mg

Question 29

what medications would a patient on level 2 bowel protocol receive

Answer 29

sennosides 24 mg and polyethylene glycol 17g

Question 30

what medications would a patient on level 3 bowel protocol receive

Answer 30

Sennosides 24 mg and polyethylene glycol 17g

Question 31

what medications would a patient on level 4 bowel protocol receive

Answer 31

if there is stool present use glycerine suppository if no response then bisacodyl suppository and if no response use a fleet enema

Question 32

what are the lengths of time since bowel movement for each level of the bowel protocol

Answer 32

Level 1-24 hours
level 2-48 hours
level 3-72 hours
level 4-96 hours

Question 33

what is the best position for a client while administering a suppository

Answer 33

left lateral position (laying on the left side)

Question 34

necrosis of a stoma is most likely to occur within how many hours after surgery

Answer 34

most likely to occur within 72 hours after surgery

Question 35

who needs to change their diet more someone with an ileostomy or colostomy

Answer 35

someone with a ileostomy since food does not pass through the large intestine

Question 36

what kind of food should people with an ileostomy avoid

Answer 36

popcorn
nuts
seeds

Question 37

when administering a cleansing enema the bag should be hung how high above the anus

Answer 37

30 cm

Question 38

the balloon of a rectal tube should be inflated with how much water

Answer 38

45 mL’s