WEB WOC OSTOMY CARE
COMPREHENSIVE EXAM STUDY GUIDE
COMPLETE QUESTIONS AND SOLUTIONS
●● abdominoperineal resection
Answer: removal of the distal colon and rectum through both abdominal
and perineal approaches
*for low rectal tumors
*creates permanent sigmoid or descending colostomy
*wide resection done = risk for sexual dysfunction
●● ACE procedure
Answer: Malone antegrade continence enema (ACE) uses the appendix
and cecum to create a catheterizable stoma to instill an antegrade enema
to empty the colon.
●● complete bowel obstruction management
Answer: become NPO, go to ER, once blockage is relieved, increase
volume of oral intake from clear liquids up to solid slowly
●● complete bowel obstruction s/s
Answer: no output
,●● continent ileostomy (kock pouch)
Answer: total proctocolectomy performed and abdominal ileal pouch is
made. The continence mechanism is a nipple valve constructed in the
pouch by intussusception.
●● crohn's disease
Answer: chronic inflammation of the intestinal tract
*Affects any portion of the GI tract
*Initially develops at terminal ileum, Cramping or steady RLQ pain,
fever, malaise, weight loss, bleeding may be occult, extracolonic
manifestations
*Transmural (affects ALL layers of bowel wall) perforation of the bowel
or fistula) mucosal inflammation and ulceration - skip areas a hallmark
*Complications include strictures, FISTULAS, and abscess formation,
bowel obstructions
*Not cured with surgery, but a remission may result. Not generally a
candidate for IPAA or other type of continent diversion
, ●● descending colostomy complications
Answer: *monitor, prevent, and manage constipation
*may cause erectile dysfunction
●● descending colostomy disease and procedure
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
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 location
Answer: LLQ
●● Detubularized
Answer: Technique for constructing a continent colonic urinary
reservoir.
COMPREHENSIVE EXAM STUDY GUIDE
COMPLETE QUESTIONS AND SOLUTIONS
●● abdominoperineal resection
Answer: removal of the distal colon and rectum through both abdominal
and perineal approaches
*for low rectal tumors
*creates permanent sigmoid or descending colostomy
*wide resection done = risk for sexual dysfunction
●● ACE procedure
Answer: Malone antegrade continence enema (ACE) uses the appendix
and cecum to create a catheterizable stoma to instill an antegrade enema
to empty the colon.
●● complete bowel obstruction management
Answer: become NPO, go to ER, once blockage is relieved, increase
volume of oral intake from clear liquids up to solid slowly
●● complete bowel obstruction s/s
Answer: no output
,●● continent ileostomy (kock pouch)
Answer: total proctocolectomy performed and abdominal ileal pouch is
made. The continence mechanism is a nipple valve constructed in the
pouch by intussusception.
●● crohn's disease
Answer: chronic inflammation of the intestinal tract
*Affects any portion of the GI tract
*Initially develops at terminal ileum, Cramping or steady RLQ pain,
fever, malaise, weight loss, bleeding may be occult, extracolonic
manifestations
*Transmural (affects ALL layers of bowel wall) perforation of the bowel
or fistula) mucosal inflammation and ulceration - skip areas a hallmark
*Complications include strictures, FISTULAS, and abscess formation,
bowel obstructions
*Not cured with surgery, but a remission may result. Not generally a
candidate for IPAA or other type of continent diversion
, ●● descending colostomy complications
Answer: *monitor, prevent, and manage constipation
*may cause erectile dysfunction
●● descending colostomy disease and procedure
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
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 location
Answer: LLQ
●● Detubularized
Answer: Technique for constructing a continent colonic urinary
reservoir.
