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jejunostomy location
CORRECT ANSWER:
LUQ
*frequently not marked by the WOC nurse
jejunostomy disease and procedure
CORRECT ANSWER:
ischemic bowel, crohn's, trauma, necrotizing enterocolitis
diversion of small bowel at jejunum, with or without colectomy, with
or without small bowel resection, loop or end stoma
jejunostomy function and management
CORRECT ANSWER:
*function begins in 24-48 hours
*initially gas, then watery clear/green output (fluid and digestive
enzymes)
*output up to 2400ml/day
*empty pouch when 1/3 to 1/2 full
jejunostomy complications
CORRECT ANSWER:
,*monitor for electrolyte imbalances and dehydration
*size pouch correctly to prevent leakage
*may need to change pouch every 2-3 days
ileostomy location
CORRECT ANSWER:
RUQ
ileostomy disease and procedure
CORRECT ANSWER:
crohn's, ulcerative colitis, familial adenomatous polyposis, trauma,
necrotizing enterocolitis, cancer, ischemic bowel
total proctocolectomy with end ileostomy, total proctocolectomy
with continent ileostomy, temporary ileostomy, temporary loop
ileostomy for ileal pouch-anal anastomosis
ileostomy function and management
CORRECT ANSWER:
*function begins in 24-48 hours
*initially gas, then liquid output for several days, then becomes
mushy
*output of 500-600 ml/day (higher output the higher up in the ileum
stoma is)
*empty pouch when 1/3 to 1/2 full
*protect peristomal skin
*watch for fluid and electrolyte imbalance
ileostomy complications
CORRECT ANSWER:
*high risk for bowel obstruction-instruct pt to chew food thoroughly
and drink lots of water
*potential risk for vitamin B12 deficiency
,transverse colostomy location
CORRECT ANSWER:
RUQ or LUQ
transverse colostomy disease and procedure
CORRECT ANSWER:
diverticulitis, colon cancer, crohn's, perforated bowel, congenital
disease (Hirschprung's)
diversion of large bowel at the transverse colon, with or without
colectomy, usually temporary loop stoma
transverse colostomy function and management
CORRECT ANSWER:
*function begins within 48 hours
*initially gas, then mushy or semi-formed
*may have urge to poop with mucous from rectum
*no effect on nutritional absorption
transverse colostomy complications
CORRECT ANSWER:
*waistline location can be difficult to manage
descending colostomy location
CORRECT ANSWER:
LLQ
descending colostomy disease and procedure
CORRECT ANSWER:
colorectal cancer, trauma, bowel perforation, ischemic bowel
permanent end colostomy with rectum and anus removed,
, temporary or permanent end colostomy with Hartmann's pouch
(sewing shut top of rectum with ability to reconnect to GI tract later)
descending colostomy function and management
CORRECT ANSWER:
*function may not begin for up to 5 days post-op
*initially gas, then liquid, then semi-formed to formed
*odor and gas of concern due to higher amounts of bacteria
*may need colostomy irrigation routinely
descending colostomy complications
CORRECT ANSWER:
*monitor, prevent, and manage constipation
*may cause erectile dysfunction
continent ileostomy (kock pouch)
CORRECT ANSWER:
total proctocolectomy performed and abdominal ileal pouch is made.
The continence mechanism is a nipple valve constructed in the
pouch by intussusception.
ileal pouch anal anastomosis (IPAA)
CORRECT ANSWER:
usually done in 1, 2, or 3 stages
the colon and most of the rectum are removed, but the anus remains
intact, a pouch is constructed from the ileum and anastomosed to
the distal rectum, a temporary loop ileostomy is created to divert
stool while the anastomosis heals, the ileostomy is taken down once
the suture lines heal and normal bowel function is restored
ileal/colon conduit location
CORRECT ANSWER: