Stoma care Flashcards
what is a stoma
artificial opening on the abdomen to divert flow of faeces or urine into an external pouch located outside of the body
name the 2 most common forms of stoma
Colostomy and ileostomy
2 med forms that are unsuitable in pt with stoma and why
Enteric-coated and modified-release medicines are unsuitable, particularly in patients with an ileostomy, as there may be insufficient release of the active ingredient.
which forms should be used
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 e.g. caps or tab is given what should you do
the contents of the stoma bag should be checked for any remnants.
why should you be aware of prescribing preparations that contain sorbitol
Preparations containing sorbitol as an excipient may have a laxative effect.
be wary of opioid analgesics because….
may cause constipation in colostomy patients
be wary of aspirin and NSAIDs because…
may cause gastric irritation and bleeding; faecal output should be monitored for traces of blood.
calcium containing antacids can cause….
constipation
magnesium containing antacids can cause…
diarrhoea, especially in patients with an ileostomy as they can cause osmotic diarrhoea.
aluminium hydroxide antacids can cause…
constipation and may be of concern in colostomy pt
how do the antidiarrhoeal drugs codeine and loperamide work
reduce intestinal motility and decrease water and sodium output from an ileostomy.
loperamide circulates through the enterohepatic circulation which is disrupted in patients with….
short bowel
pt with stoma are particularly susceptible to what
fluid and sodium depletion
this can often lead to hypokalaemia
potassium supplements usually not required
what can diuretics do
may cause excessive dehydration in patients with an ileostomy or with urostomy and potassium depletion may easily occur; potassium-sparing diuretics are available.
what may iron preps do
may cause diarrhoea in ileostomy patients, constipation in colostomy patients, and sore skin if output leaks; stools may also appear black.
if pt are unable to tolerate gI adverse effects of oral iron, what is licensed that you can give instead
parenteral iron
why are laxatives used with caution in ileostomy pt
Laxatives may cause rapid and severe loss of water and electrolytes in ileostomy patients and are, therefore, used with caution.
which laxative is more beneficial in colostomy pt?
In colostomy patients, bulk-forming laxatives may provide more benefit than a stimulant laxative; they aid in the formation of solid stools and promote regularity
Liquid formulations of potassium supplements are preferred to modified-release formulations; to avoid osmotic diarrhoea how is it given?
daily dose is split into divided doses.
