stoma examination

Question 1

overview of stoma examination

Answer 1

1 - wiper intro
2 - inspection
3 - ascultation
4 - conclusion

Question 2

intro

Answer 2

WIPER

expose from xiphisternum to pubic symphysis

pain. problems with stoma (ASK)

Question 3

inspection of stoma

Answer 3

1 - site (l v r)
2 - number of lumens. single = end ileostomy/colostomy. double = defunctioning, easier reversal.
3 - spouted or not. spouted = ileostomy, flush = colostomy
4 - effluent (feel the bag = hard, soft, urine)
5 - surrounding skin quality . Cough for hernias.(inflammation/excoriation)
6 - complications
7 - offer digital examination of stoma
8 - rest of abdo for reason for stoma e.g. no anus = AP resection.

Question 4

ascultation of the stoma

Answer 4

bowel sounds just below the umbilicus. obstruction is a possible complication.

Question 5

conclusion

Answer 5

ask to check the stoma output chart - is it high or low output.

i would do a full GI and genitourinal examination.

PT comfort and dressed and thank

Question 6

reason for ileostomy

Answer 6

END%
Total%colectomy%
Panproctocolectomy(
(e.g.(in(UC,(polyp(
disorders)(
(
LOOP%
Anterior%resecHon%
(rectal(tumor(removed(
and(colon(anastomosed(
with(remaining(rectal(
stump;(requires(a(
temporary(defuncLoning(
(loop)(ileostomy(/(
colonostomy).(

Question 7

reason for colostomy

Answer 7

Permanent%END%
AP%resecHon%
(e.g.(in(lowNlying(rectal(
tumour).(
(
Temporary%END%
Hartmann’s%procedure%
(A{er(sigmoid(colectomy(
e.g.(for(perforated(
diverLculiLs)(

Question 8

reason for urostomy

Answer 8

Total%cystectomy%
E.g.(for(TCC(bladder(
cancer(
(
Note%–%normally%spouted