Stoma Care Flashcards
What is a stoma?
an artificial opening on the abdomen to divert flow of faeces or urine into an external pouch located outside of the body; may be temporary or permanent
What are the different types of GI stomas? (6)
- Colostomy (most common)
- Ileostomy (most common)
- Gastrostomy
- Jejunostomy
- Duodenostomy
- Cecostomy
Prescribing for patients with a stoma calls for special care due to modifications in _______________, resulting in a higher risk of sub-optimal absorption
drug delivery
Prescribing for patients with a stoma calls for special care due to modifications in drug delivery, resulting in a higher risk of _________________
sub-optimal absorption
Are enteric-coated and modified-release medicines suitable for patients with stomas?
NO, particularly in patients with an ileostomy (may be insufficient release of the active ingredient)
- Preparation forms with quick dissolution and absorption should be used. Liquids, capsules, and uncoated or soluble tablets are usually well absorbed
Enteric-coated and modified-release medicines are unsuitable, particularly in patients with a(n) _________________, as there may be insufficient release of the active ingredient
ileostomy
*Preparation forms with quick dissolution and absorption should be used. Liquids, capsules, and uncoated or soluble tablets are usually well absorbed
When a solid-dose form of medicine such as a capsule or a tablet is given, the _______________ should be checked for _______________
contents of the stoma bag
any remnants
Preparations containing ______________ as an excipient may have a laxative effect in patients with stomas
sorbitol
Opioid analgesics may cause constipation in _____________ patients
colostomy
Aspirin and NSAIDs may cause gastric irritation and bleeding in patients with stomas; _____________ should be monitored for _____________
faecal output
traces of blood
The effect of antacids in patients with a stoma is dependent on the class of antacids and the type of stoma.
- Calcium-containing antacids can cause _____________
- magnesium-containing antacids can cause _____________
- aluminum-containing antacids can cause _____________
Constipation
Diarrhea
Constipation
Calcium-containing antacids can cause constipation and magnesium-containing antacids can cause diarrhoea, especially in patients with a(n) _______________ as they can cause osmotic diarrhoea
ileostomy
The aluminium hydroxide antacids can cause constipation and may be of concern in ______________ patients
colostomy
The antidiarrhoeal drugs, loperamide hydrochloride and codeine phosphate, reduce _________________ and decrease _____________ output from an ileostomy
intestinal motility
water and sodium
The antidiarrhoeal drugs, _____________ and _____________, reduce intestinal motility and decrease water and sodium output from an ileostomy
loperamide hydrochloride
codeine phosphate
Loperamide hydrochloride circulates through the enterohepatic circulation, which is disrupted in patients with a(n) _________________
short bowel
Patients with a stoma are particularly susceptible to __________________ depletion which can often lead to hypokalaemia
fluid and sodium
- potassium supplements are not usually required
Patients with a stoma are particularly susceptible to fluid and sodium depletion which can often lead to ______________
hypokalaemia
- potassium supplements are not usually required
Hypokalaemia caused by fluid and sodium depletion in a paient with a stoma may cause an increased sensitivity to _____________
digoxin
_______________ may cause excessive dehydration in patients with an ileostomy or with urostomy and potassium depletion may easily occur
Diuretics
- potassium-sparing diuretics are available
Diuretics may cause excessive dehydration in patients with a(n) _________________ or with ________________ and potassium depletion may easily occur; potassium-sparing diuretics are available
ileostomy
urostomy
____________ preparations may cause diarrhoea in ileostomy patients, constipation in colostomy patients, and sore skin if output leaks
Iron
Iron preparations may cause diarrhoea in _____________ patients, constipation in _____________ patients, and ______________ if output leaks
ileostomy
colostomy
sore skin
______________ iron is licensed for use in patients who are unable to tolerate gastro-intestinal adverse effects of oral iron
Parenteral
____________ may cause rapid and severe loss of water and electrolytes in ileostomy patients and are, therefore, used with caution
Laxatives
Laxatives may cause rapid and severe loss of ______________ and ______________ in ileostomy patients and are, therefore, used with caution
water
electrolytes
Laxatives may cause rapid and severe loss of water and electrolytes in _____________ patients and are, therefore, used with caution
ileostomy
In colostomy patients, ________________ laxatives may provide more benefit than a(n) ______________ laxative; they aid in the formation of solid stools and promote regularity
bulk-forming
stimulant
- Stool softeners can also help with constipation
In _____________ patients, bulk-forming laxatives may provide more benefit than a stimulant laxative; they aid in the formation of solid stools and promote regularity
colostomy
Vs caution using laxatives in ileostomy patients due to risk of water and electrolyte depletion
In patients with stomas who have hypokalemia, ____________ formulations of potassium supplements are preferred to ______________ formulations; to avoid osmotic diarrhoea, the daily dose is split into divided doses
Liquid
modified-release
In patients with stomas who are being treated for hypokalemia, liquid formulations of potassium supplements are preferred to modified-release formulations; to avoid osmotic diarrhoea, the daily dose is ___________________
Is split into divided doses
Patients and their carers are usually given advice about the use of _______________, _______________, ______________, _______________, or _______________ whilst in hospital either by the surgeon or by stoma care nurses
Cleansing agents Protective creams Lotions Deodorants Sealants
*voluntary organizations are also available to offer help and support
