Ostomy exam prep questions and answers graded A

IPAA Ileal pouch anal anastomosis. Entire colon is removed. Ileum used to create a J pouch, which is then connected to the anus. Done in stages. Stage 1: loop ileostomy and pouch created. Stool diverted through ileostomy while pouch matures (7-10 weeks). Stage 2: reconnected IPAA is most commonly done to treat which condition? ulcerative colitis What is the best surgical procedure for Crohn's affecting the large intestine? total proctocolectomy and ileostomy continent ileostomy, kock pouch Reservoir pouch is created inside the abdomen with a portion of the terminal ileum. A valve is then constructed in the pouch and a stoma is brought through the abdominal wall. A catheter or tube in inserted into the pouch several times a day to drain feces from the reservoir Kock pouch post-op care pouch connected to cath for 14 days, irrigated 3x/day after 2 weeks start progressive clamping of tube for gradual pouch expansion cath removed on day 24 post-op, continue to irrigate and intubate BCIR Barnett Continent Intestinal Reservoir improvement upon the Kock continent ileostomy Enteral feeding tube with continuous feedings: how often should it be flushed, and with how much water? every 4 hours with 30ml of water, also flush before and after med administration Signs of an impending EC fistula localized erythema, induration. local discomfort With a triple lumen GJ tube, which port should be used for feeding? The Jejunal port. Gastric port is used for decompression and meds. DC instructions for new nephrostomy tube change gauze dressing daily for first 2 weeks, then change twice weekly and PRN soiling How do you keep a hemovac drain patent? Milk or strip it to remove blood clots and tissue shreds ileal conduit stoma site marking right lower quadrant ileal conduit stoma site marking for an obese patient right upper quadrant APR (abdominoperineal resection) removal of rectum, anus and sphincter. Permanent end colostomy of sigmoid colon placed through LLQ. When does stomal necrosis occur? within first 24 hours of creation treatment of mucocutaneous separation fill defect with ostomy powder, fit appliance over the defect Which medications should be avoided with an ileostomy or transverse colostomy? enteric coated or ER After surgical closure of the ileostomy, what happens to the superficial skin? Left to close by secondary intention How can gas be managed by an ileostomate? eating small, frequent meals Pouches should be emptied when how full? 1/3 to 1/2 full normal ileostomy output after creation: 800-1700 levels off to: 500-1800 IPAA for high risk or acute colitis patients is better to be performed in how many stages? 3 stages: 1. subtotal colectomy with double ended ileostomy and sigmoidostomy. rectum remains. 2. IPAA, rectum removed, j pouch attached, diverting ileostomy. 3. ileostomy closed When collecting a sterile urine sample from an ileal conduit, how much urine do you need? 5-10 ml Definitive treatment for mucosal transplantation surgical excision Management of mucosal transplantation stoma powder to absorb mucus secreted by the tissue A peristomal bulge that is usually visualized in the standing or sitting position is actually a________________________ peristomal hernia Which kind of a pouching system should never be used with a peristomal hernia? Convexity, because it may cause: pressure ulcers, loosening of the system with change in body countours, stoma laceration.