WEB WOC OSTOMY CARE
QUESTIONS & ANSWERS(RATED A+)
jejunostomy location - ANSWERLUQ
*frequently not marked by the WOC nurse
jejunostomy disease and procedure - ANSWERischemic 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 - 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 - ANSWER*monitor for electrolyte imbalances and
dehydration
*size pouch correctly to prevent leakage
*may need to change pouch every 2-3 days
ileostomy location - ANSWERRUQ
ileostomy disease and procedure - ANSWERcrohn'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 - 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 - 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 - ANSWERRUQ or LUQ
, transverse colostomy disease and procedure - ANSWERdiverticulitis, 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
ileal/colon conduit disease and procedure - ANSWERbladder cancer, neurogenic
bladder, refractory interstitial cystitis, pre-existing small bowel disease indicates use of
colon conduit instead
segment of small bowel is brought to the skin and anastomosed with the ureters,
sigmoid colon is used instead of small bowel in colon conduit
ileal/colon conduit function and management - ANSWER*functions immediately with
clear or blood tinged urine
*mucous threads are normal as the conduit was made from bowel which secretes
mucous
*empty pouch when 1/3 to 1/2 full, change every 3-7 days
*can attach to straight drainage at night/in bed for prolonged periods
ileal/colon conduit complications - ANSWER*hyperchloremic hypokalemic metabolic
acidosis
*pyelonephritis or long term kidney damage
*late onset vitamin B12 deficiency
indiana pouch location - ANSWERRLQ
indiana pouch disease and procedure - ANSWERbladder cancer, neurogenic bladder,
pelvic exenteration
reservoir is constructed from distal ileum, ileocecal valve (continence mechanism), and
portion of right colon, many variations (Mainz, Miami, Florida, Studor, Mitrofanoff - uses
appendix)
*continent urinary diversion = urine is emptied from the reservoir by catheterization
indiana pouch function and management - ANSWER*functions immediately with clear of
blood-tinged urine
*pouch capacity initially small but will expand to 300-500 mL
*post-op the pouch will have a Malecot catheter to irrigate the pouch and a Foley
catheter to drain the urine
*after pouch-o-gram to confirm healing, pt will be taught to self cath
indiana pouch complications - ANSWER*pouchitits (s/s: sudden explosive loss of urine,
increased mucous, abd. pain, fever, malaise)
QUESTIONS & ANSWERS(RATED A+)
jejunostomy location - ANSWERLUQ
*frequently not marked by the WOC nurse
jejunostomy disease and procedure - ANSWERischemic 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 - 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 - ANSWER*monitor for electrolyte imbalances and
dehydration
*size pouch correctly to prevent leakage
*may need to change pouch every 2-3 days
ileostomy location - ANSWERRUQ
ileostomy disease and procedure - ANSWERcrohn'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 - 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 - 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 - ANSWERRUQ or LUQ
, transverse colostomy disease and procedure - ANSWERdiverticulitis, 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
ileal/colon conduit disease and procedure - ANSWERbladder cancer, neurogenic
bladder, refractory interstitial cystitis, pre-existing small bowel disease indicates use of
colon conduit instead
segment of small bowel is brought to the skin and anastomosed with the ureters,
sigmoid colon is used instead of small bowel in colon conduit
ileal/colon conduit function and management - ANSWER*functions immediately with
clear or blood tinged urine
*mucous threads are normal as the conduit was made from bowel which secretes
mucous
*empty pouch when 1/3 to 1/2 full, change every 3-7 days
*can attach to straight drainage at night/in bed for prolonged periods
ileal/colon conduit complications - ANSWER*hyperchloremic hypokalemic metabolic
acidosis
*pyelonephritis or long term kidney damage
*late onset vitamin B12 deficiency
indiana pouch location - ANSWERRLQ
indiana pouch disease and procedure - ANSWERbladder cancer, neurogenic bladder,
pelvic exenteration
reservoir is constructed from distal ileum, ileocecal valve (continence mechanism), and
portion of right colon, many variations (Mainz, Miami, Florida, Studor, Mitrofanoff - uses
appendix)
*continent urinary diversion = urine is emptied from the reservoir by catheterization
indiana pouch function and management - ANSWER*functions immediately with clear of
blood-tinged urine
*pouch capacity initially small but will expand to 300-500 mL
*post-op the pouch will have a Malecot catheter to irrigate the pouch and a Foley
catheter to drain the urine
*after pouch-o-gram to confirm healing, pt will be taught to self cath
indiana pouch complications - ANSWER*pouchitits (s/s: sudden explosive loss of urine,
increased mucous, abd. pain, fever, malaise)
