Lab 6 Ostomy-Rectal Meds-Enemas-Rectal Tubes Flashcards
how full should an ostomy pouch be before you change it
empty when 1/3 full
how often is an ostomy pouch changed
depends on pouch but usually every 3-5 days
when is the best time to change an ostomy pouch
either before breakfast or 1-2 hours after
what type of drainage would a colostomy have
semi formed to mostly formed stool since most of the intestine remains intact so stool still forms
what dietary changes need to be made for a person with a colostomy
usually people do not need to make major changes since most of the intestine remains intact
what type of drainage would there be from an ileostomy
less formed liquid stool since more of the intestine has been bypassed or removed
what are two nursing care priorities for someone who has an ileostomy
-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
would a person with an ileostomy require more fluids than a person with a colostomy
yes since the more intestine you have removed the more fluids are lost since there is less time for absorption
What is the most common type of urostomy
ileal conduit which is where a piece of ilium is taken to create a stoma for the urinary system
how often is a urostomy pouch changed
every 2-7 days
does a bowel resection always result in the formation of an ostomy
no since they can sometimes perform anastomosis which is when the rejoin the two ends of the bowel
What is a hartmann’s procedure
when there is a part of bowel left in place beyond the stoma so it may be reversed at a later time
what is a loop ostomy
bowel is not completely severed and instead a loop of bowel is brought through the skin
what is a double barrel stoma
when the bowel is cut into to sections and both sections are brought to the surface
What is the biggestconcern when a PT has a stoma prolapse
May compromise the circulation of the stoma
what is mucocutaneous separation
when the stoma starts to become detached from the skin that surrounds it
what is the difference between contact dermatitis and irritant dermatitis
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
What device is used right after an ostomy surgery to ensure that caregivers don’t have to press to hard on the skin
A low pressure adapter which gives the clinician more finger space so they don’t have to press to hard on the patient
what type of ostomy would a closed end pouch be used
usually used for a colostomy since the PT is probably producing fully formed stool and it might only happen once a day
what product would a nurse use if they wanted to keep skin dry and keep the pouching system well adhered to the skin
stomahesive powder
What products can be used to fill gaps around the bag and protect the skin of the patient
Stoma paste and barrier rings/strips
What is the goal of ostomy irrigation
The goal is to train the bowel to empty at the same time each day
What are two important medication considerations to make for a patient with an ileostomy
-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
What is the goal of a cleansing enema
used to promote complete evacuation by stimulating peristalsis with large volume of fluid
what is the goal of a carminative enema
to stimulate peristalsis and expel flatus
what is the goal of an oil retention enema
Lubricates the rectum and the feces absorbs the oil which softens the stool
what suppository would be used to soften the stool
glycerin suppository since it draws more water into the intestine to make the stool softer
What suppository would be used to stimulate more peristalsis to produce a bowel movement
bisacodyl suppository
what medications would a patient on level 1 bowel protocol receive
they would receive sennosides 12 mg
what medications would a patient on level 2 bowel protocol receive
sennosides 24 mg and polyethylene glycol 17g
what medications would a patient on level 3 bowel protocol receive
Sennosides 24 mg and polyethylene glycol 17g
what medications would a patient on level 4 bowel protocol receive
if there is stool present use glycerine suppository if no response then bisacodyl suppository and if no response use a fleet enema
what are the lengths of time since bowel movement for each level of the bowel protocol
Level 1-24 hours
level 2-48 hours
level 3-72 hours
level 4-96 hours
what is the best position for a client while administering a suppository
left lateral position (laying on the left side)
necrosis of a stoma is most likely to occur within how many hours after surgery
most likely to occur within 72 hours after surgery
who needs to change their diet more someone with an ileostomy or colostomy
someone with a ileostomy since food does not pass through the large intestine
what kind of food should people with an ileostomy avoid
popcorn
nuts
seeds
when administering a cleansing enema the bag should be hung how high above the anus
30 cm
the balloon of a rectal tube should be inflated with how much water
45 mL’s
