Ostomy

Question 1

Large intestine

Answer 1

colon, water absorption

Question 2

small intestine

Answer 2

Major organ for Digestion and Absorption of nutrients (no water)

Contains lots of digestive enzymes!

Question 3

Sigmoid Colostomy

Answer 3

Stool usually semi-solid to solid consistency
Usually no dietary restrictions
Odor & Gas can be a problem
Rectal Cancer - #1 reason for permanent colostomy

Question 4

Ileostomy

Answer 4

Potential for food blockage bc small lumen of small intestine
No colon to absorb water, so drink 8-10 glasses a day
Can dehydrate easily – Call MD if vomiting and diarrhea
Caution with fibrous food – chew well
Caution with Medications – less time in digestive tract -
watch for extended release tablets or enteric coated meds
Must protect peristomal skin – digestive enzyme in output – caustic!

Question 5

Healthy stoma

Answer 5

Red and moist, easy to bleed.
No feeling (bc no nerve endings) – does not hurt
Will shrink 1st 1-2 months
No sphincter – no control

Question 6

Temporary ostomy

Answer 6

Divert stool to allow healing.

Usually for trauma, diverticulitis, pressure ulcers, etc.

Question 7

Permanent ostomy

Answer 7

Rectum or bladder is removed.

Usually for rectal cancer or bladder cancer.

Question 8

APR (Abdominal-Perineal Resection)

Answer 8

Removal of distal bowel (rectum and anus)
Formation of a permanent end stoma.
Often done for Rectal Cancer
Will have rectal incision

Question 9

Double barrel ostomy

Answer 9

Resection of affected bowel.
Proximal end brought out as functioning colostomy (or ileostomy)
Distal end brought out as “mucous fistula” (will produce mucus)

Question 10

Ostomy care guidlines

Answer 10

Stoma – should be red & moist.
Change pouch 1 - 2 times per week.
Empty pouch when 1/3 full.
Shower with pouch on or off.
Maintain fluids- Drink 8 -10 cups fluid per day.
Call your MD for: changes in stoma, skin irritation, vomiting, abdominal swelling or cramping

Question 11

Urostomy

Answer 11

Used for patients with bladder cancer
Must be observed continuously for signs of infection
Increased risk for UTI – call MD for s/sx (fever, cloudy urine, odor, chills, backache, malaise)
Drink plenty of fluids to keep conduit flushed.
Connect pouch to bedside drain at night to prevent overfilling of pouch.