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Surgery > Stoma > Flashcards

Stoma Flashcards

1
Q

What What is classification stoma

A

According to duration and requirement
according to the type
according to the site
according to the function

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2
Q

What are the two types of stoma according to the duration

A

Temporary permanent

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3
Q

What are the types of a stoma

A

Loop
end
double barral

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4
Q

What are the functions of the stoma

A

Elimination feeding defunction

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5
Q

What are the sites of the systems use the stoma

A 
G.I. track  =oesophagus stomach duodenum jejanum ileum colon
 Respiratory track= trachea and lung
Urinary system =kidney 
ureter
 bladder
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6
Q

What are the complications of stoma

A

Early within one week

late after one week

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7
Q

What are early complications of stoma

A 
Ischemic necrosis
 retraction
 mucocutaneous separation 
hemorrhage 
skin excoriation
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8
Q

What are late complications of the stoma

A 
Skin excoriation
 mucocutaneous separation
 prolapse 
parastomal hernia
 retraction
 stenosis obstruction of the small bowel
 hemorrhage
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9
Q

What are the dietary advises should do for colostomy patient

A

Ask to take low fiber diet to reduce the stool bulk and prevent obstruction
Avoid vegetables result in a offensive odour
Avoid vegetable which reduce flatus
Avoid the smoking
chew food well
Drink adequate amount of water

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10
Q

What is the principal in making colostomy and ileostomy

A

Ileostomy sprouted at least 2 cm from skin level

Colostomy mucosa level with skin

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11
Q

How to prevent the complications of the stoma

A

Correct sitting correct technique good family education good nursing care

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12
Q

How to manage the complications of a storma

A 
Early detection 
Correct diagnosis
 nursing care
 refashioning 
resitting
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13
Q

How to identify the retraction of the stoma

A

Appear flush or below the skin level

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14
Q

What are the causes for Stoma re traction

A

Obesity
early removal of a stoma rod
stoma placement in stoma fold

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15
Q

How to manage stoma retraction

A

Conservative management
Use convex pouching system
stoma supporting Belt

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16
Q

What is mucocutaneous separation of stoma

A

Detachment of stoma from your skin

17
Q

What is the causes for mucocutaneous separation

A

Poor wound healing
suture line tension
DM
malnutrition

18
Q

How to manage mucocutaneous separation

A

Manage as wound (calcium alginate and silver dressing)
Use two piece pouching system
apply stoma products
avoid convex pouching system

19
Q

What is the storm prolaps

A

Stoma becoming longer six inches or more

20
Q

What are the reasons for stonal prolapse

A

Obesity
heavy lifting
increase abdominal pressure
Poor muscle tone

21
Q

How to manage stoma prolapse

A 
Conservative management
 large pouching
 reduce stoma size manually
 storm is support belt 
 surgical repair
22
Q

What is parastomal hernia

A

Swelling of the abdomen around the stoma pain and discomfort

23
Q

Causes for parastomal hernia

A 
Obesity 
age 
Sitting of  the stoma outside the rectus muscle 
pressure in the abdominal cavity
 weakness of the abdominal wall
24
Q

How to manage parastomal hernia

A

Conservative management
avoid heavy lifting
support belt
flexible pouching system

25
Q

What is the stoma skin excoriation

A

Irritation of the peristomal skin

26
Q

What are the causes for irritation of peristomal skin

A

Leaking
wrong method of appliances change
wrong cleaning method of peristomal skin

27
Q

How to manage skin excoriation

A

Educated patient about appliances change

Use stoma adhesive powder or past

28
Q

What is stenosis of stoma

A

Narrowing or constriction of stoma at skin level

29
Q

Causes for stenosis of stoma

A

● Hard, fibrous ring formed around suture
● Too small abdominal opening for the stoma
● Neoadjuvent RT before surgery
● Crohn’s disease

30
Q

How to manage the stenosis of the stoma

A

Low residual diet
Increase fluid intake
Use the stool softeners for colostomies
Educated patient about intestinal obstruction

31
Q

How to identify necrosis of stoma

A

Stoma appear black , dull ,dusky color usually occur within five days need immediately for surgical intervention

32
Q

Causes for the necrosis of the stoma

A

Poor blood supply

vascular compromise

33
Q

What is the management for necrosis of the storm

A

Transparent pouching system

immediately for surgical intervention

34
Q

For what stomas skin care is more impotant

A

Urological Stomas

Surgery (7 decks)

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