OSTOMY CARE UPDATED EXAM COMPREHENSIVE
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔Because the ileum contains digestive enzymes and acids that cause skin irritation,
extra care is required to keep waste materials from contacting the abdominal surface.
Initially, stool output may be as high as 1,000 to 2,000 mL per day, putting some
patients at risk for dehydration - ✔✔
✔✔Urostomy - ✔✔A urostomy is 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, an ileal conduit can be created. For this type of surgery, a
loop of 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 out through the abdominal
wall to form a stoma. The remaining ileum is reconnected to the rest of the digestive
tract. This is the most common type of urinary diversion.
✔✔r this type of surgery, - ✔✔a loop of 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 out through the abdominal wall to form a stoma. The remaining ileum is
reconnected to the rest of the digestive tract. This is the most common type of urinary
diversion.
✔✔A continent internal ileal reservoir or continent ileal bladder conduit (Kock's pouch) is
created the same way as an ileal conduit is, - ✔✔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. Filling pressure closes the valves,
thereby preventing leakage and reflux. An external drainage collection device is not
necessary because the patient self-catheterizes about every 4 hours.
✔✔An Indiana continent urinary reservoir is formed from the cecum and a portion of the
ileum - ✔✔. The created stoma is continent and flush with the skin. The patient self-
catheterizes to empty the reservoir.
With a ureterostomy, one or both ureters are redirected from the kidney(s) through the
abdominal wall to form a stoma. To avoid the need for two collecting devices, a
transureteroureterostomy may be performed to connect the ureters internally and bring
one out through the abdominal wall. WHen the bladder is nonfunctional.
✔✔With a urostomy, - ✔✔urine will flow as it is produced because the patient has no
voluntary control over urine flow. An external pouching system or collection device
contains the urine. Urostomy pouches have a drainage tap on the bottom for emptying
them repeatedly throughout the day.
✔✔Patient Care - ✔✔Instructional strategies include describing each step of the
procedure performed, encouraging participation in ostomy care, answering questions,
, and providing resources until patients are comfortable with performing the procedure
independently.
✔✔Teach patients with a new stoma the techniques to use for cleansing, signs and
symptoms of stoma or peristomal skin complications, and application and management
of the pouching system. - ✔✔
✔✔A healthy stoma appears pink or red and moist, and should protrude about ¾ inch (2
cm) from the abdominal wall. Teach patients to report any stoma that turns dusky,
brown, black, or very pale to the provider immediately as these findings indicate
compromised circulation. Make sure they understand the type of cleansing agent to use
on the peristomal skin, typically a mild, pH-balanced soap or no soap at all and just
water. Using other products such as alcohol, povidone-iodine (Betadine), or oil-based
soap can interfere with the adhesion of the skin barrier and could promote skin
breakdown. - ✔✔
✔✔Emphasize the need to measure the stoma weekly over the first 8 weeks following
surgery to verify that the opening of the pouch is the correct size. - ✔✔
✔✔The pouching system must fit so the skin - ✔✔at the base of the stoma is covered,
but not so that it constricts or exerts pressure on the stoma. If the stoma size changes
or a patient has problems with the pouching system, recommend a pouch refitting with a
wound ostomy continence nurse.
✔✔Instruct patients to notify their clinician for any of the following: - ✔✔1. increased
pain in the abdomen or the incision; fever, redness, or drainage of the incision; or
irritation, redness, or breakdown of the peristomal skin
2. change in bowel habits, such as diarrhea or constipation
3. skin irritation unrelieved by a properly fitting pouching
4. system problems obtaining a good seal of the wafer or 5. skin barrier a hernia or
bulge around the stoma
6. narrowing of the stoma lumen
7. separation of the stoma from the abdominal surface lacerations or cuts in the stoma
✔✔Follow-up care
Patients should follow up regularly with the surgeon and the wound ostomy continence
nurse. Patients will want to know when they can resume their usual activities. Most can
do so with minimal restrictions after the stoma has healed adequately. It is important to
give them specific information about exercise and sexual activity and to make sure it
matches what their provider has prescribed or recommended for them. - ✔✔Exercise.
Ostomy patients should be advised to remain vigilant of their hydration status during
strenuous physical activity. Patients should engage in a regular exercise routine that
includes activities that promote cardiovascular and musculoskeletal fitness.
Sexuality. It is important for patients to expect to feel sensitive about the change in body
image. Encourage them to share feelings with their partners and to respond to any
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔Because the ileum contains digestive enzymes and acids that cause skin irritation,
extra care is required to keep waste materials from contacting the abdominal surface.
Initially, stool output may be as high as 1,000 to 2,000 mL per day, putting some
patients at risk for dehydration - ✔✔
✔✔Urostomy - ✔✔A urostomy is 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, an ileal conduit can be created. For this type of surgery, a
loop of 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 out through the abdominal
wall to form a stoma. The remaining ileum is reconnected to the rest of the digestive
tract. This is the most common type of urinary diversion.
✔✔r this type of surgery, - ✔✔a loop of 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 out through the abdominal wall to form a stoma. The remaining ileum is
reconnected to the rest of the digestive tract. This is the most common type of urinary
diversion.
✔✔A continent internal ileal reservoir or continent ileal bladder conduit (Kock's pouch) is
created the same way as an ileal conduit is, - ✔✔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. Filling pressure closes the valves,
thereby preventing leakage and reflux. An external drainage collection device is not
necessary because the patient self-catheterizes about every 4 hours.
✔✔An Indiana continent urinary reservoir is formed from the cecum and a portion of the
ileum - ✔✔. The created stoma is continent and flush with the skin. The patient self-
catheterizes to empty the reservoir.
With a ureterostomy, one or both ureters are redirected from the kidney(s) through the
abdominal wall to form a stoma. To avoid the need for two collecting devices, a
transureteroureterostomy may be performed to connect the ureters internally and bring
one out through the abdominal wall. WHen the bladder is nonfunctional.
✔✔With a urostomy, - ✔✔urine will flow as it is produced because the patient has no
voluntary control over urine flow. An external pouching system or collection device
contains the urine. Urostomy pouches have a drainage tap on the bottom for emptying
them repeatedly throughout the day.
✔✔Patient Care - ✔✔Instructional strategies include describing each step of the
procedure performed, encouraging participation in ostomy care, answering questions,
, and providing resources until patients are comfortable with performing the procedure
independently.
✔✔Teach patients with a new stoma the techniques to use for cleansing, signs and
symptoms of stoma or peristomal skin complications, and application and management
of the pouching system. - ✔✔
✔✔A healthy stoma appears pink or red and moist, and should protrude about ¾ inch (2
cm) from the abdominal wall. Teach patients to report any stoma that turns dusky,
brown, black, or very pale to the provider immediately as these findings indicate
compromised circulation. Make sure they understand the type of cleansing agent to use
on the peristomal skin, typically a mild, pH-balanced soap or no soap at all and just
water. Using other products such as alcohol, povidone-iodine (Betadine), or oil-based
soap can interfere with the adhesion of the skin barrier and could promote skin
breakdown. - ✔✔
✔✔Emphasize the need to measure the stoma weekly over the first 8 weeks following
surgery to verify that the opening of the pouch is the correct size. - ✔✔
✔✔The pouching system must fit so the skin - ✔✔at the base of the stoma is covered,
but not so that it constricts or exerts pressure on the stoma. If the stoma size changes
or a patient has problems with the pouching system, recommend a pouch refitting with a
wound ostomy continence nurse.
✔✔Instruct patients to notify their clinician for any of the following: - ✔✔1. increased
pain in the abdomen or the incision; fever, redness, or drainage of the incision; or
irritation, redness, or breakdown of the peristomal skin
2. change in bowel habits, such as diarrhea or constipation
3. skin irritation unrelieved by a properly fitting pouching
4. system problems obtaining a good seal of the wafer or 5. skin barrier a hernia or
bulge around the stoma
6. narrowing of the stoma lumen
7. separation of the stoma from the abdominal surface lacerations or cuts in the stoma
✔✔Follow-up care
Patients should follow up regularly with the surgeon and the wound ostomy continence
nurse. Patients will want to know when they can resume their usual activities. Most can
do so with minimal restrictions after the stoma has healed adequately. It is important to
give them specific information about exercise and sexual activity and to make sure it
matches what their provider has prescribed or recommended for them. - ✔✔Exercise.
Ostomy patients should be advised to remain vigilant of their hydration status during
strenuous physical activity. Patients should engage in a regular exercise routine that
includes activities that promote cardiovascular and musculoskeletal fitness.
Sexuality. It is important for patients to expect to feel sensitive about the change in body
image. Encourage them to share feelings with their partners and to respond to any
