NUR 144 - Week 4 - Fecal Diversino Flashcards
Describe Pre-Op Care for a patient undergoing an ostomy
- Fluids and blood replacement prn
- Antibiotics as prescribed
- Diet = small frequent meals & low residue, high protein
- Mark surgical site (visible to patient)
- Pre-Op teaching
Describe Post-Op care for a patient with an ostomy
- Early ambulation
- Respiratory consideration
- Monitor for bleeding/infection
- Pain meds
Ostomy
- Stoma color
- Swelling is normal
- Clear dressing
- Monitor for fecal drainage
(Usually 24-48hrs ileostomy
Usually 3-6 days colostomy)
Emotional Support
- Grief is common
- Pt may need education abt sexual function, pregnancy, recreational activities
- Delay education is pt not receptive
What are factors to consider in ostomy care?
- Ileostomy or Colostomy
- Temporary or permanent
- Continent (as in incontinence vs. continent; do they have control over it?)
- Capped
- Irrigation
Post-Op Ostomy Drainage:
Ileostomy
- Continuous liquid drains to a pouch
- no sphincter, no control over drainage
- Stoma will shrink first few weeks post-op
Post-Op Ostomy Drainage:
Continent ileal reservoir (Kock pouch)
- Continuous drainage collect in the indwelling
- reservoir for 2-3 weeks post-op
Post-Op Ostomy Drainage:
Transverse colostomy
- Soft unformed
- No sphincter, no control over drainage
- Drains to a pouch
Post-Op Ostomy Drainage:
Descending or Sigmoid Colostomy
- More solid stool
- No sphincter, no control over drainage
- Drains to a pouch
Assessments to make on the stoma
- Skin complications higher with ilesotomy
- More than trace blood or bright red blood = abnormal
Assess for skin breakdown
- Allergies: appliance, skin barrier, paste
- Chemical irritant
- Mechanical injjury
Which ostomy has higher risk of skin complications?
Ileostomy
Food considerations for stoma patient
Increased fluid intake
Avoid indigestible fiber (think corn = blocks tube)
Deodorizing foods
- Spinach
- Parsley
- Bismuth sub carbonate (3-4 per day as prescribed)
Odor producing foods
- Asparagus
- Cabbage
- Onions
- Fish
