OST 580 - FINAL REVIEW STUDY GUIDE 3 Questions and Answers correct

OST 580 - FINAL REVIEW STUDY GUIDE 3 Questions and Answers correct The creation of a fecal stoma with a mucous fistula may be indicated in which of the following conditions? Toxic megacolon 3 multiple choice options What complication would the WOC nurse assess for in a patient with an ureteroscopy? Hydronephrosis 3 multiple choice options Which procedure is the most common urinary diversion? Ileal conduit 3 multiple choice options The WOC nurse is explaining the procedure for constructing an ileal conduit to a patient scheduled for the surgery. Which statement by the nurse adequately describes a step in this procedure? Gastrointestinal continuity is restored through ileal to ileal anastomosis. 3 multiple choice options A support rod is placed under a loop stoma to prevent which of the following stoma complications? Retraction 3 multiple choice options A patient is scheduled for surgery for an abdominal perineal resection (APR). What type of stoma will be created during this procedure? Permanent end colostomy 3 multiple choice options The WOC nurse can help patients with their fears and concerns as they face surgery for an ostomy by Providing the opportunity for a visit with a trained ostomy visitor 3 multiple choice options The WOC nurse is teaching a patient with a new stoma about pouching systems. Which teaching point accurately describes an important aspect of using a pouching system? The usual wear time for a pouch is 4 days. 3 multiple choice options If the surgeon is siting the stoma during the case in the OR, what advice would you give for general information for stoma site marking? Ideally, the stoma should be placed on the apex of the abdominal infra-umbilical bulge. 3 multiple choice options The patient with ulcerative colitis who is being prepared for a surgical procedure to create a permanent end ileostomy should receive preoperative education that includes the following: Help the patient to understand that they can live a full life without a colon and a rectum. 3 multiple choice options The WOC nurse helps prepare the patient for ostomy surgery by Determining the patient's emotional support system 3 multiple choice options The WOC nurse counsels patients regarding lifestyle issues following stoma surgery. What statement accurately describes an important teaching tip? Most patients will not have to follow a special diet once healing takes place. 3 multiple choice options The first skill the patient with a colostomy should learn before discharge is How to empty the pouch 3 multiple choice options The WOC nurse should include the preoperative education sessions for an 80-year-old gentleman scheduled for an ileal conduit Pouch system demonstration 3 multiple choice options The WOC nurse has a consult for stoma site marking for a patient scheduled for an ileal conduit. Where should the stoma most likely be marked? Right abdomen 3 multiple choice options The WOC nurse is assessing the seal of a skin barrier for a patient with an ileostomy. The peristomal skin is intact but slightly reddened. The nurse notes that the skin barrier material is undermined with stool. What could this finding indicate? Excessive wear time that allowed skin exposure to the effluent 3 multiple choice options The WOC nurse assessing the peristomal skin of a patient in a sitting position notes that there are creases and folds in the peristomal skin. What shape of skin barrier would the nurse recommend for this patient? Convex 3 multiple choice options What factors determine the size and shape of the opening of a solid skin barrier? Size and shape of the stoma 3 multiple choice options For which patient would the use of skin barrier paste be contraindicated? A patient with a urostomy 3 multiple choice options A WOC nurse assesses the area around a patient's stoma and notes that it is not level on the lateral side next to the stoma. The following products are available; which product would be the best option for this patient? Skin barrier paste 3 multiple choice options The WOC nurse is helping a patient with a new urinary diversion choose a pouching system. The stoma is located in an area that is hard for the patient to visualize, and a two-piece pouching system is recommended. What is an advantage of this type of system? It allows for application of the skin barrier without the pouch obstructing the view 3 multiple choice options For which patient would the nondrainable pouch be the best option? A patient with a colostomy who has formed to semiformed stool once a day 3 multiple choice options A WOC nurse is counseling a patient with a colostomy about gas management for his pouching device. What teaching point accurately describes gas control features? Most pouches with gas filters are effective for 24-36 hrs 3 multiple choice options When assessing the fit of the skin barrier to the stoma, what guides the size of the skin barrier opening? The opening should fit to the stoma-skin junction with no skin showing 3 multiple choice options The WOC nurse is teaching a patient with a fecal diversion about accessory products available for use. Which statement accurately describes one of these products? Absorbent crystals can be placed in the pouch to turn effluent into a gel. 3 multiple choice options At a postoperative follow-up visit 2 weeks after hospital discharge, your patient with an ileostomy complains of burning and itching of the peristomal skin. She usually changes her pouching system twice a week, but often experiences leakage at night resulting in extra pouch changes. Her peristomal skin is erythematous and weeping around the stoma, and there is partial thickness skin loss extending 3 inches below the stoma. Which of the following complications is most likely? Peristomal moisture-associated skin damage 3 multiple choice options Your patient with a colostomy changes his pouching system every 3 to 4 days and has not experienced leakage between pouch changes. When you remove the pouching system, you note a linear area of stripped skin at the upper edge of the skin barrier. What aspect of his self-care may be contributing to this complication? Removing the skin barrier incorrectly 3 multiple choice options A 48 year old man with an ileostomy created 15 years prior reports multiple episodes of bleeding near his stoma. He has purple discoloration of the peristomal skin and small defects at the stoma edge oozing blood. His medical history includes ulcerative colitis and primary sclerosing cholangitis resulting in cirrhosis. What is the most likely cause of bleeding? Peristomal varices 3 multiple choice options One of your patients with a colostomy and history of colorectal cancer has scattered peristomal erythematous papules at the mucocutaneous junction. The patient is getting a good fit with a presized convex barrier pouch and skin barrier rings. You have followed the patient three times over the past 2 months and you have applied silver nitrate to the lesions at each visit. Despite treatments, there has been no significant improvement. Which of the following interventions are indicated? Referral to an advanced ostomy practice provider or dermatologist 3 multiple choice options A patient you do not know well has called you complaining of pruritis around his urostomy. He has a clinic appointment the following week and wants some ideas about managing the itch today. What additional information is essential to ask before making recommendations? Stoma size, barrier opening size, presence or absence of leakage 3 multiple choice options The urostomy is more likely than other ostomy types to be associated with what peristomal skin complications? PMASD, pseudoverrucous lesions 3 multiple choice options Your patient has painful nonhealing peristomal wounds you suspect may be due to pyoderma gangrenosum and you are providing her with a referral to dermatology. What interim stoma/skin care is recommended for this patient? Absorbent wound products and a flat pouching system 3 multiple choice options Your patient with a loop ileostomy for Crohn's disease has a flush oval stoma in a skin fold. He uses a presized soft convex product with an ostomy belt. He reports tenderness and bleeding around the stoma. When you remove the pouching system, you notice erythematous firm papules in a crescent shape just below the stoma. Given this history, what do you suspect is the cause? Granulomas due to moisture exposure from effluent 3 multiple choice options What principles apply to the management of patients with a stoma and autoimmune diseases? Select nonadherent wound dressings when needed, use adhesive removers at every pouching system change, collaborate with a dermatology specialist 3 multiple choice options What do patients need to know about preventing and managing peristomal skin complications? Look at the skin and take action if it is persistently red or no longer intact 3 multiple choice options Which patient with an ostomy would be considered at higher risk for developing ostomy complications? A patient who has a diverting loop procedure performed 3 multiple choice options Which patient would the nurse recognize as having an EARLY stomal complication? A patient experiencing death of the stoma tissue resulting from impaired blood flow 3 multiple choice options Which assessment by the nurse confirms a diagnosis of stomal retraction? The stoma disappears in line with or below skin level 3 multiple choice options A patient is diagnosed with stomal retraction. What is NOT a goal of management for this patient? Use stomal dilation to temporarily aid in evacuation 3 multiple choice options The nurse is managing the care of a patient who has a stomal prolapse and the stoma is edematous. Which intervention is most appropriate for this patient? Sprinkle sugar over the prolapsed stoma 3 multiple choice options A nurse with a new stoma complains to the nurse: "I can't always get the pouching system sealed tightly, and then it leaks!" The nurse notes bulging of the peristomal area. What condition would the ostomy nurse suspect is occurring? Parastomal hernia 3 multiple choice options What is a treatment choice for a patient with parastomal hernia who is asymptomatic? Hernia support belt/garment 3 multiple choice options A patient with a stoma reports pain with stoma evacuation and small, ribbon-like stools. What stoma complication may be present? Stoma stenosis 3 multiple choice options A patient with a new stoma is diagnosed with a large mucocutaneous separation. What condition is likely to occur due to this defect? Retraction of the stoma 3 multiple choice options A patient with a parastomal hernia is scheduled for surgical repair. What type of repair is the preferred method? Stomal relocation to the opposite side of the abdomen. 3 multiple choice options The WOC nurse suspects that a patient's surgical wound is developing a fistula. Which of the following is the definitive indicator of an enterocutaneous fistula? Passage of gastrointestinal secretions or urine into an open wound bed 3 multiple choice options A patient is diagnosed with an enterocutaneous fistula with a high output volume. Which statement correctly defines this diagnosis? A passage is created from the intestine to the skin, and the volume is 500 mL/24h 3 multiple choice options The WOC nurse is assessing the wound of a patient diagnosed with a type 1 complex fistula. What data regarding the fistula would the nurse document in the patient record? Fistula with an abscess, with multiple organ involvement 3 multiple choice options What is the etiology of the majority of enterocutaneous fistulas (ECFs)? Surgical procedures 3 multiple choice options The WOC nurse is planning care for a patient with an enterocutaneous fistula (ECF). What is a key initial step in managing a patient with ECF? Limit oral or enteral intake to amount keeping intestinal mucosa healthy. 3 multiple choice options