Lab 6 Ostomy-Rectal Meds-Enemas-Rectal Tubes Flashcards

1
Q

how full should an ostomy pouch be before you change it

A

empty when 1/3 full

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2
Q

how often is an ostomy pouch changed

A

depends on pouch but usually every 3-5 days

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3
Q

when is the best time to change an ostomy pouch

A

either before breakfast or 1-2 hours after

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4
Q

what type of drainage would a colostomy have

A

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

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5
Q

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

A

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

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6
Q

what type of drainage would there be from an ileostomy

A

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

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7
Q

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

A

-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

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8
Q

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

A

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

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9
Q

What is the most common type of urostomy

A

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

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10
Q

how often is a urostomy pouch changed

A

every 2-7 days

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11
Q

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

A

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

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12
Q

What is a hartmann’s procedure

A

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

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13
Q

what is a loop ostomy

A

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

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14
Q

what is a double barrel stoma

A

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

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15
Q

What is the biggestconcern when a PT has a stoma prolapse

A

May compromise the circulation of the stoma

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16
Q

what is mucocutaneous separation

A

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

17
Q

what is the difference between contact dermatitis and irritant dermatitis

A

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

18
Q

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

A

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

19
Q

what type of ostomy would a closed end pouch be used

A

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

20
Q

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

A

stomahesive powder

21
Q

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

A

Stoma paste and barrier rings/strips

22
Q

What is the goal of ostomy irrigation

A

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

23
Q

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

A

-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

23
Q

What is the goal of a cleansing enema

A

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

24
what is the goal of a carminative enema
to stimulate peristalsis and expel flatus
25
what is the goal of an oil retention enema
Lubricates the rectum and the feces absorbs the oil which softens the stool
26
what suppository would be used to soften the stool
glycerin suppository since it draws more water into the intestine to make the stool softer
27
What suppository would be used to stimulate more peristalsis to produce a bowel movement
bisacodyl suppository
28
what medications would a patient on level 1 bowel protocol receive
they would receive sennosides 12 mg
29
what medications would a patient on level 2 bowel protocol receive
sennosides 24 mg and polyethylene glycol 17g
30
what medications would a patient on level 3 bowel protocol receive
Sennosides 24 mg and polyethylene glycol 17g
31
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
32
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
33
what is the best position for a client while administering a suppository
left lateral position (laying on the left side)
34
necrosis of a stoma is most likely to occur within how many hours after surgery
most likely to occur within 72 hours after surgery
35
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
36
what kind of food should people with an ileostomy avoid
popcorn nuts seeds
37
when administering a cleansing enema the bag should be hung how high above the anus
30 cm
38
the balloon of a rectal tube should be inflated with how much water
45 mL's