Module III Quiz Flashcards
Peristomal candidiasis: risks
Corticosteroids
Immunosuppressants
Antibiotics
Prevents spontaneous fistula closure
Distal bowel obstruction
Purpose of skin sealant under fistula pouch
Protect from mechanical injury (stripping)
Preterm infant surface area to body weight ratio
Avoid use of skin solvents
More surface area to absorb chemicals in sealants, barrier paste, adhesives
Skin barrier wafers have 0 solvents or chemicals
Primary intervention for treatment/prevention of pseudoverrucous lesions
Resize pouch to fit base of stoma and cover up lesions
Silver nitrate and pseudoverrucous lesions
Painful
Unnecessary as lesions will resolve w/ removal of urine
Complications causing mortality w. fistulas
Sepsis
Malnutrition
F/E imbalance
Pt w/ isolated episodes of dusky stoma coloration
Infant
Crying = blood shunted away from bowel
Returns to red after crying stops
Primary feature of EC fistula pouching system
Sizable surface for cutting
Fistulas in all shapes/sizes
Colostomy irrigation w/ hernia
Discontinue irrigations if problematic or caustic
Pseudoverrucous lesions: contributing factors
Due to chronic overexposure to moisture
ex: oversized pouch
Risk factor for stomal stenosis
Necrosis
Replacement of low-profile G tube
Measure length of stoma tract
Too small = necrosis, pain, tenderness
Vinegar soaks used for:
Encrustations
30-50% vinegar solution when pouch removed
Risks for stomal prolapse
Infant (high ABD pressure from crying) Loop colostomy (limited securing of bowel to skin)
Caput Medusae caused by:
Portal hypertension in alcoholic or liver disease pt
Incarcerated bowel associated with:
Parastomal hernia
May contain loop of bowel in herniation = ischemia
s/s ischemia: ABD pain, n/v, change in stoma color
Permanent ileostomy w/ ulcer producing fecal material
Crohn’s disease = fistula formation
Criteria for selecting EC fistula pouch
Volume of effluent
Size of fistula
Odor
Need for access
Black/flaccid stoma: interventions
Rub stoma to note surface bleeding
Prepare to examine stoma w/ glass tube and light
Mucocutaneous separation of new stoma
Preoperative corticosteroid use Poor healing Tension Superficial infection DM Malnutrition Stoma necrosis Recurrence of disease
Encrustations
Deposits of urinary crystals of stoma and peristomal skin
G tube care
Stabilize tube
Interventions to prevent G tube clog
Liquid meds only