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Nursing 172 > Week 12: Ostomy Care > Flashcards

Week 12: Ostomy Care Flashcards

1
Q

Allergic contact dermatitis

A

inflammation of the skin resulting from contact with an allergen

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2
Q

Anastomosis

A

formation of a connection between two usually distinct structures or portions of a structure

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3
Q

Cecostomy

A

surgical creation of an opening from the beginning of the large intestine (cecum) to the abdominal wall

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4
Q

Cohesion

A

ability of the skin to maintain its integrity when exposed to moisture

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5
Q

Colostomy

A

surgically created opening (stoma) from the colon (large intestine) to the abdominal wall to allow stool to pass out of the body
-created from the end of the large intestine to divert waste from the digestive system

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6
Q

Conduit

A

passageway

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7
Q

Cystectomy

A

excision or resection of the bladder

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8
Q

Denudation

A

stripping of superficial skin surface

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9
Q

filtered pouch

A

ostomy output collection bag that incorporates an odor filtration apparatus

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10
Q

Flange

A

rim used for attachment to another object, such as a ostomy pouch attaching to a skin barrier

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11
Q

Flatus

A

gas or air generated in the stomach and/or intestines and expelled via the anus or an intestinal ostomy

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12
Q

Hartmann Procedure

A

common temporary colostomy surgery that involves leaving the distal portion of the colon in place and over sewn for closure to create a Hartmann’s pouch

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13
Q

Hydrocolloids

A

substance that forms a gel as fluid is absorbed and is used in some ostomy products to absorb perspiration and other metabolic secretions while preventing fungal and bacterial invasion

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14
Q

Hydronephrosis

A

enlargement of the kidneys as urine collects in the renal pelvis and kidney tissue

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15
Q

Hyperplasia

A

abnormal increase in the volume of a tissue or organ

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16
Q

Ileal conduit

A

surgical removal of a section at the end of the small bowel (ileum) and relocation as a passageway for urine from the kidneys to the outside of the body through a stoma

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17
Q

Ileostomy

A

surgical opening created in the ileum to bypass the entire large intestine

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18
Q

Irritant Dermatitis

A

inflammation of the skin resulting from contact with an irritating substance

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19
Q

Kock Pouch

A

internal pouch created from the distal segment of the ileum to serve as a reservoir for stool or urine

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20
Q

Luminal Bleeding

A

blood seeping through the opening (lumen) of a stoma

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21
Q

Maceration

A

softening or dissolution of tissue after lengthy exposure to fluid

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22
Q

Mucocutaneous Separation

A

separation of the stoma from the peristomal skin; also called mucocutaneous detachment

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23
Q

Peristomal retraction

A

pulling in of the skin around a stoma when the stoma is drawn inward below the skin level

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24
Q

Peristomal skin

A

skin surrounding an ostomy

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25
Q

Pouching system

A

one-piece or two-piece device that includes a skin barrier/ wafer and a collection pouch for output; referred to as an appliance

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26
Q

Reservoir

A

storage place; in the case of an IPAA or kocks pouch, an internal reservoir is surgically created

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27
Q

Sigmoid

A

referring to the portion of the large intestine between the descending colon and the rectum

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28
Q

Skin Stripping

A

mechanical disruption of the epidermis, as can be caused by adhesives when an ostomy appliance is removed

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29
Q

Stoma

A

surgically created opening, usually referring to one in the abdominal wall

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30
Q

Stomal height

A

degree of protrusion of a stoma from the skin

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31
Q

Stomal prolapse

A

lengthening of a stoma due to the bowel telescoping out through the stoma

32
Q

Stomal Retraction

A

pulling back of a stoma below skin level

33
Q

Stomal stenosis

A

narrowing of the lumen of the stoma

34
Q

Tap

A

device on a urostomy pouch that permits drainage of the contents

35
Q

Ureter

A

narrow tubular duct that transports urine from the kidney to the bladder

36
Q

Ureterostomy

A

surgically created ureteral skin opening that diverts urine away from the bladder and out of the body

37
Q

Urostomy

A

surgically created opening that diverts urine away from the bladder and out of the body

38
Q

Valsalva Maneuver

A

forceful exhalation against a closed glottis, which involves contraction of the abdominal muscles to propel feces out of the body

39
Q

Wafer

A

faceplate or barrier designed to protect the peristomal skin from the stoma output and to which the pouch is attached

40
Q

Ostomy

A

opening surgically created in the abdominal wall to allow for elimination of urine or feces
>may be temporary, to allow for healing and a return to normal elimination or permanent

41
Q

Ostomy surgery

A

performed when a disorder or an injury keeps the urinary or gastrointestinal system from functioning properly

42
Q

Ostomy surgery is indicated for?

A
  • congenital abnormalities
  • bladder, colon, and rectal cancer
  • inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
  • inherited disorders; familial adenomatous polyposis
  • obstruction of the ureter
  • stab or gunshot wounds to the abdomen
43
Q

How long do you have an ostomy for?

A

may be temporary, to allow for healing and a return to normal elimination, or permanent

44
Q

3 primary types of ostomy surgery?

A
  • colostomy
  • ileostomy
  • urostomy
45
Q

What should a stoma look like?

A

surgically created opening in the skin of the abdomen

  • should be shiny, wet, and red in color; similar to mucous membranes in the mouth
  • can be round, oval, or irregular in shape
  • can be protruding, flush with the skin, or retracted
46
Q

Colostomy

A
  • surgically created opening (stoma) from the colon (large intestine) to the abdominal wall to allow stool to pass out of the body
  • created from the end of the large intestine to divert waste from the digestive system
47
Q

3 Different Colostomy types

A
  • End colostomy
  • Loop colostomy
  • Double-barrel colostomy
48
Q

End Colostomy

A

the damaged section of the bowel is removed and the working end is brought through the abdomen to the skin surface
-used when a colostomy is intended to be permanent

49
Q

Loop Colostomy

A

a loop of the bowel is brought through the abdomen to the skin surface and temporarily supported by a plastic bridge or rod
>a transverse loop colostomy–> is typically created as an emergency procedure to relieve an intestinal obstruction or perforation; a communicating wall remains between the proximal and distal bowel; it has two opening through the one stoma- the proximal end drains the stool while distal portion drains mucous
-bridge can be removed in 7 to 10 days
-transverse loop colostomies are temporary

50
Q

Double-barrel Colostomy

A

2 separate stomas are created

  • both ends of the bowel are brought through the abdomen to the skin surface
  • the distal colon is not removed but bypassed
  • the proximal stoma, diverts feces to the abdominal wall
  • distal expels mucus from distal colon
51
Q

Locations of a colostomy

A

-ascending (liquid to semi-liquid)
-transverse (liquid to semi-formed)
-descending (semi-formed)
-sigmoid (formed)
>because more formed as water is absorbed

52
Q

Colostomy in the ascending colon: output formation

A

liquid to semi-liquid and is very irritating to the surrounding skin

53
Q

Colostomy in the transverse colon (mid-abdomen)

A

for temporary ostomy with stoma constructed as a loop

-output is liquid to semi-formed

54
Q

Colostomy in the descending colon (left upper abdomen)

A

semi-formed because more water is absorbed while fecal material is in the ascending and transverse colon

55
Q

Colostomy in the sigmoid colon (left lower abdomen)

A

for a permanent colostomy, particularly for cancer of the rectum

  • output is formed
  • stoma is typically located on the lower left quadrant
56
Q

Ileostomy

A

a surgical opening created in the ileum to bypass the entire large intestine
-stoma located in right lower quadrant

57
Q

Proctocolectomy

A

procedure to treat colon cancer and ulcerative colitis involves surgical removal of the entire colon, rectum, and anus

  • with closure of the anus, resulting in need for stool diversion; as part of the total proctocolectomy, the end of the terminal ileum is brought out through the abdominal wall, forming a permanent ileostomy
  • no more control over bowel movements
58
Q

Restorative Proctocolectomy with IPAA (ileal pouch anal anastomosis)

A

involves connecting the ileum to a “new” rectum or (“anal pouch”) also made out of a portion of ileum; it is procedure of choice where rectum can be preserved, allowing patient to retain anal sphincter control of bowel movements; patient will have a temporary loop ileostomy to divert stool while this new anal pouch heals followed by closure of the ostomy a few months later

59
Q

Kocks Continent Ileostomy “kocks pouch”

A

an internal pouch is created from the distal segment of the ileum, which serves as a reservoir for stool
-during surgery, a one-way nipple valve is constructed through the stoma opening so that eventually the patient can insert a catheter through the stoma and through the one-way valve to drain the fecal contents of the internal pouch
>created for ulcerative colitis or for patients who do not wish to wear an external pouch over the stoma

60
Q

Urostomy

A

urinary diversion that allows urine to exit the body after removal of a diseased or damaged section of the urinary tract
-when the entire bladder must be removed a ileal conduct can be created

61
Q

How can a ileal conduct be created?

A

when the entire bladder must be removed
-a loop of the intestinal ileum is separated and used as a conduit for urine; the ureters are attached to the ileal conduit and the open end is brought through the abdominal wall to form a stoma; the remaining ileum is reconnected to GI tract

62
Q

How is Kocks Pouch created

A

created the same way ileal conduit except that nipple valves are formed by intussuscepting tissue backward into the reservoir; the pouch is connected to the skin and the ureters are connected to the pouch

63
Q

Indiana Continent Urinary Reservoir

A

formed from the cecum and a portion of the ileum

  • stoma is continent and flush with the skin
  • patient self-catheterizes to empty reservoir with a ureterostomy, one or both ureters are redirected from the kidneys through the abdominal wall to form a stoma
  • to avoid the need for 2 collecting devices, a transureterostomy may be performed to connect the ureters internally and bring one out through the abdominal wall
64
Q

Ileostomy Management

A

drainage is typically dark green, loose, and odorless; drainage gradually thickens and becomes yellow to brown

  • empty pouch when it is 1/3 to 1/2 full
  • use skin barrier; bile contains enzymes and bile salt that can irritate skin
65
Q

Ileostomy drainage

A

typically dark green, loose, and odorless; drainage gradually thickens and becomes yellow to brown
-empty pouch when it is 1/3 to 1/2 full

66
Q

Common manifestations of Ileostomy

A

abdominal cramping, nausea, vomiting, stoma swelling, and no ileostomy output for 6 hours

67
Q

Interventions for manifestations

A
  • place moist towels on the abdomen
  • drink hot tea
  • lie down and assume a knee-chest position to relieve intraabdominal pressure
  • massage the abdominal area to promote peristalsis and fecal elimination
68
Q

Diet for Colostomy

A

can resume a regular diet

-fresh fruits, vegetables, protein-sources, and whole-grain bread and cereals

69
Q

Ileostomy Diet

A
  • higher risk for fluid + electrolyte imbalances due to shorter transit time through bowel
  • 10 to 12 glasses of water per day to prevent dehydration and blockage
  • chew food thoroughly to help pass it through narrow ileum
  • need to avoid high-fiber foods for the first 6-8 weeks to avoid blockage after surgery
70
Q

Urostomy Diet

A

no dietary restrictions

-consume plenty of fluid

71
Q

Pouching Systems

A
  • Closed end pouches
  • Drainable pouches
  • One-piece systems
  • Two-piece systems
72
Q

Pouching system: Closed end pouches

A

designed for one-time use and my meet the needs of a patient who irrigates

  • sigmoid colostomies
  • when full, it is removed from the skin barrier and discarded
73
Q

Pouching System: Drainable pouches

A

can be rinsed and re-used

  • use with ascending or transverse colostomy, ileostomy, and urostomy
  • have a tap instead of a clip
74
Q

Pouching System: One-piece systems

A

with an attached skin barrier, available in cut-to-fit and pre-cut types

75
Q

Pouching System: Two-piece systems

A

permits frequent pouch changes and minimizes skin breakdown

  • pouch and skin barrier connected with a flange mechanism
  • pouch may be disposable or reusable
  • may have a filter for gas release

Nursing 172 (120 decks)

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