OST580 MODULE 2 QUIZ WITH
COMPLETE SOLUTIONS 100%
CORRECT (GRADED A+)
Question 1: Postoperative Assessment of a New Ileal Conduit
During the first routine pouch change after an ileal conduit has been created,
which of the following observations is considered normal?
a. The stoma is dusky at the mucocutaneous junction.
b. The stoma is edematous and pink.
c. The stoma has no output.
d. A constant trickle of blood from the mucocutaneous junction is present.
✔✔ Answer: b. The stoma is edematous and pink.
Clinical Rationale & Assessment Standards:
Expected Baseline Appearance: Immediately post-op and during initial
pouch changes, a new stoma is typically edematous (swollen) and pink to
cherry-red in color due to surgical manipulation and fluid shifts. Over the
first 6–8 weeks, the edema will gradually subside, and the stoma will shrink
to its permanent size.
Why the other choices indicate emergency or abnormal findings:
o a (Dusky color): A dark, purple, dusky, or black stoma indicates
ischemia or necrosis due to compromised vascular blood supply.
This requires immediate notification of the surgical team.
o c (No output): Unlike bowel stomas (which may take a few days to
produce stool), a urinary diversion must have immediate and
continuous urine output. Absence of urine output signals ureteral
obstruction, acute kidney injury, or a dislodged stent, representing a
medical emergency.
o d (Trickle of blood): While minor capillary bleeding from the stoma
tissue itself during cleaning is common, a constant trickle at the
, mucocutaneous suture line suggests active hemorrhage or wound
dehiscence and must be addressed.
Question 2: Dietary Management & Odor Control
Which of the following foods is known to cause considerable odor for the
patient with a urinary diversion?
a. Beets
b. Cheese
c. Greasy, French fries
d. Fish
✔✔ Answer: d. Fish
Clinical Rationale & Patient Teaching:
Odor-Producing Foods in Urinary Diversions: Certain foods produce
volatile metabolites excreted in urine that significantly increase pouch odor.
Fish, asparagus, eggs, garlic, and onions are prime culprits known to cause
strong, distinct urine odors.
Discoloration vs. Odor: Beets (a) cause harmless red or pink discoloration
of the urine (beturia), which can easily be mistaken for hematuria (blood),
but they do not cause significant odor.
Management Tip: To manage urine odor without restricting diet
unnecessarily, WOC nurses recommend maintaining adequate fluid intake
(to dilute the urine) and using specialized pouch deodorizers or liquid drops
inside the pouch system.
Not many things really cause odor in the urine but fish, asparagus, vitamins are
notorious for urinary odor. It is important to note because patients will actually call
you because the odor is so bad, and you may think of a UTI initially if you don't
first ask about their diet.
The primary rationale for using a skin barrier paste is to:
a. fill or "caulk" irregular surfaces at the base of the stoma.
b. increase the tack of the adhesive surface on the abdomen.
COMPLETE SOLUTIONS 100%
CORRECT (GRADED A+)
Question 1: Postoperative Assessment of a New Ileal Conduit
During the first routine pouch change after an ileal conduit has been created,
which of the following observations is considered normal?
a. The stoma is dusky at the mucocutaneous junction.
b. The stoma is edematous and pink.
c. The stoma has no output.
d. A constant trickle of blood from the mucocutaneous junction is present.
✔✔ Answer: b. The stoma is edematous and pink.
Clinical Rationale & Assessment Standards:
Expected Baseline Appearance: Immediately post-op and during initial
pouch changes, a new stoma is typically edematous (swollen) and pink to
cherry-red in color due to surgical manipulation and fluid shifts. Over the
first 6–8 weeks, the edema will gradually subside, and the stoma will shrink
to its permanent size.
Why the other choices indicate emergency or abnormal findings:
o a (Dusky color): A dark, purple, dusky, or black stoma indicates
ischemia or necrosis due to compromised vascular blood supply.
This requires immediate notification of the surgical team.
o c (No output): Unlike bowel stomas (which may take a few days to
produce stool), a urinary diversion must have immediate and
continuous urine output. Absence of urine output signals ureteral
obstruction, acute kidney injury, or a dislodged stent, representing a
medical emergency.
o d (Trickle of blood): While minor capillary bleeding from the stoma
tissue itself during cleaning is common, a constant trickle at the
, mucocutaneous suture line suggests active hemorrhage or wound
dehiscence and must be addressed.
Question 2: Dietary Management & Odor Control
Which of the following foods is known to cause considerable odor for the
patient with a urinary diversion?
a. Beets
b. Cheese
c. Greasy, French fries
d. Fish
✔✔ Answer: d. Fish
Clinical Rationale & Patient Teaching:
Odor-Producing Foods in Urinary Diversions: Certain foods produce
volatile metabolites excreted in urine that significantly increase pouch odor.
Fish, asparagus, eggs, garlic, and onions are prime culprits known to cause
strong, distinct urine odors.
Discoloration vs. Odor: Beets (a) cause harmless red or pink discoloration
of the urine (beturia), which can easily be mistaken for hematuria (blood),
but they do not cause significant odor.
Management Tip: To manage urine odor without restricting diet
unnecessarily, WOC nurses recommend maintaining adequate fluid intake
(to dilute the urine) and using specialized pouch deodorizers or liquid drops
inside the pouch system.
Not many things really cause odor in the urine but fish, asparagus, vitamins are
notorious for urinary odor. It is important to note because patients will actually call
you because the odor is so bad, and you may think of a UTI initially if you don't
first ask about their diet.
The primary rationale for using a skin barrier paste is to:
a. fill or "caulk" irregular surfaces at the base of the stoma.
b. increase the tack of the adhesive surface on the abdomen.
