Ostomy exam prep 2023 with complete solution
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?
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?
