Ostomy care ATI Exam Questions and
Answers 117 Q&A. 2025/2026.
An ostomy is an opening
surgically created in the abdominal wall to allow for the elimination of urine or feces.
Ostomy surgery is performed
when a disorder or an injury keeps the urinary or gastrointestinal system from functioning properly.
Indications for ostomy surgery include:
congenital anomalies
bladder, colon, and rectal cancer
inflammatory bowel diseases (Crohn's disease, ulcerative colitis)
inherited disorders such as familial adenomatous polyposis
obstruction of the ureter
stab or gunshot wounds to the abdomen
Depending on the disorder or injury, the ostomy may be temporary, to allow for healing and a return
to normal elimination, or permanent. The three primary types of ostomy surgery are:
colostomy
ileostomy
urostomy
The surgically-created opening in the skin of the abdomen is called a
stoma. A stoma is the communicating end of the bladder or bowel that is brought to the surface of
the abdomen. The location of the stoma depends upon the location of the patient's beltline, the
location of any scars and skin folds, where the damage is, and the type of ostomy surgery
performed. The stoma should be shiny, wet, and red in color, similar to the mucous membranes of
the mouth. A stoma can be round, oval, or irregular in shape, and either protruding, flush with the
skin, or retracted.
A colostomy is created from the end of the large intestine to divert waste from the digestive system.
Three different colostomy types can be formed from the gastrointestinal tract:
1. End ( Hartmans pouch)
2. Loop
3. Double barrel
With an end colostomy, t
1. the damaged section of the bowel is removed and the working end is brought through the
abdomen to the skin surface.
2. When a colostomy is intended to be permanent, an end stoma is typically created.
3. A temporary colostomy may be performed to allow bowel rest or healing, such as following tumor
resection.
A common temporary colostomy surgery involves
,leaving the distal portion of the colon in place, which is oversewn for closure to create what is
known as a Hartmann's pouch. Anastomosis of the severed portions of the colon may be delayed for
several reasons, including bowel inflammation or tumor location.
With a loop colostomy,
a loop of the bowel is brought through the abdomen to the skin surface and temporarily supported
by a plastic bridge or rod. A transverse loop colostomy is typically created as an emergency
procedure to relieve an intestinal obstruction or perforation. A communicating wall remains
between the proximal and the distal bowel. It has two openings through the one stoma - the
proximal end drains stool while the distal portion drains mucus. The bridge can be removed in 7 to
10 days. Transverse loop colostomies are typically temporary.
Loop colostomy
With a double-barrel colostomy,
Two separate stomas are created. Both ends of the bowel are brought through the abdomen to the
skin surface as two separate sections. Typically the distal colon is not removed but bypassed. The
proximal stoma, which is functional, diverts feces to the abdominal wall. The distal stoma, or mucous
fistula, expels mucus from the distal colon.
Depending on the area of disease or injury and other physical features of the patient's abdomen, a
colostomy is placed in one of the following four locations:
1. Ascending colon
2. Transvers colon
3. Descending Colon
4. Sigmoid Colon.
Ascending colon (right abdomen).
The output is typically liquid to semi-liquid and is very irritating to the surrounding skin.
, Transverse colon (mid-abdomen). This location is used for a temporary ostomy, with the stoma
constructed as a loop. Output is liquid to semi-formed.
output- liquid to semiformed
Descending colon (left upper abdomen).
The output is semi-formed because more water is absorbed while fecal material is in the ascending
and transverse colon.
Sigmoid colon (left lower abdomen). T
his is the location for a permanent colostomy, particularly for cancer of the rectum. The stoma is
typically located on the lower left quadrant of the abdomen, and the output is formed.
An ileostomy is a surgical opening created in the ileum to bypass the entire large intestine. A
procedure used to treat colon cancer and ulcerative colitis, total proctocolectomy, involves surgical
removal of the entire colon, rectum, and anus, with closure of the anus, resulting in the need for
stool diversion.
As part of the total proctocolectomy procedure,
1. The end of the terminal ileum is brought out through the abdominal wall, forming a permanent
ileostomy.
2. After this type of ileostomy surgery, the patient has no voluntary control of bowel movements.
3. The stoma of an ileostomy is typically located in the right lower quadrant.
A restorative proctocolectomy with IPAA (ileal pouch anal anastomosis) involves connecting the
ileum to a "new" rectum (or anal pouch),
also made out of a portion of ileum; it is the procedure of choice in cases where the rectum can be
preserved, allowing the patient to retain anal sphincter control of bowel movements. The patient
will have a temporary loop ileostomy to divert stool while this new anal pouch heals, followed by
closure of the ostomy a few months later.
An alternative to the standard ileostomy
is Kock's continent ileostomy. During the procedure, an internal pouch is created from the distal
segment of the ileum, which serves as a reservoir for stool.
-During surgery, a one-way nipple valve is constructed through the stomal opening so that
eventually the patient can insert a catheter through the stoma and through the one-way valve to
drain the fecal contents of the internal pouch.
-This type of ostomy is occasionally created to treat ulcerative colitis and may be an option for
patients who do not wish to wear an external pouch over the stoma. However, the complication rate
associated with a continent ileostomy is usually higher than with a traditional ileostomy. The patient
empties the pouch several times a day and the stoma is covered with a protective dressing or a
stoma cap.
.
the complication rate associated with a continent ileostomy is usually higher than with a traditional
ileostomy.
.
Answers 117 Q&A. 2025/2026.
An ostomy is an opening
surgically created in the abdominal wall to allow for the elimination of urine or feces.
Ostomy surgery is performed
when a disorder or an injury keeps the urinary or gastrointestinal system from functioning properly.
Indications for ostomy surgery include:
congenital anomalies
bladder, colon, and rectal cancer
inflammatory bowel diseases (Crohn's disease, ulcerative colitis)
inherited disorders such as familial adenomatous polyposis
obstruction of the ureter
stab or gunshot wounds to the abdomen
Depending on the disorder or injury, the ostomy may be temporary, to allow for healing and a return
to normal elimination, or permanent. The three primary types of ostomy surgery are:
colostomy
ileostomy
urostomy
The surgically-created opening in the skin of the abdomen is called a
stoma. A stoma is the communicating end of the bladder or bowel that is brought to the surface of
the abdomen. The location of the stoma depends upon the location of the patient's beltline, the
location of any scars and skin folds, where the damage is, and the type of ostomy surgery
performed. The stoma should be shiny, wet, and red in color, similar to the mucous membranes of
the mouth. A stoma can be round, oval, or irregular in shape, and either protruding, flush with the
skin, or retracted.
A colostomy is created from the end of the large intestine to divert waste from the digestive system.
Three different colostomy types can be formed from the gastrointestinal tract:
1. End ( Hartmans pouch)
2. Loop
3. Double barrel
With an end colostomy, t
1. the damaged section of the bowel is removed and the working end is brought through the
abdomen to the skin surface.
2. When a colostomy is intended to be permanent, an end stoma is typically created.
3. A temporary colostomy may be performed to allow bowel rest or healing, such as following tumor
resection.
A common temporary colostomy surgery involves
,leaving the distal portion of the colon in place, which is oversewn for closure to create what is
known as a Hartmann's pouch. Anastomosis of the severed portions of the colon may be delayed for
several reasons, including bowel inflammation or tumor location.
With a loop colostomy,
a loop of the bowel is brought through the abdomen to the skin surface and temporarily supported
by a plastic bridge or rod. A transverse loop colostomy is typically created as an emergency
procedure to relieve an intestinal obstruction or perforation. A communicating wall remains
between the proximal and the distal bowel. It has two openings through the one stoma - the
proximal end drains stool while the distal portion drains mucus. The bridge can be removed in 7 to
10 days. Transverse loop colostomies are typically temporary.
Loop colostomy
With a double-barrel colostomy,
Two separate stomas are created. Both ends of the bowel are brought through the abdomen to the
skin surface as two separate sections. Typically the distal colon is not removed but bypassed. The
proximal stoma, which is functional, diverts feces to the abdominal wall. The distal stoma, or mucous
fistula, expels mucus from the distal colon.
Depending on the area of disease or injury and other physical features of the patient's abdomen, a
colostomy is placed in one of the following four locations:
1. Ascending colon
2. Transvers colon
3. Descending Colon
4. Sigmoid Colon.
Ascending colon (right abdomen).
The output is typically liquid to semi-liquid and is very irritating to the surrounding skin.
, Transverse colon (mid-abdomen). This location is used for a temporary ostomy, with the stoma
constructed as a loop. Output is liquid to semi-formed.
output- liquid to semiformed
Descending colon (left upper abdomen).
The output is semi-formed because more water is absorbed while fecal material is in the ascending
and transverse colon.
Sigmoid colon (left lower abdomen). T
his is the location for a permanent colostomy, particularly for cancer of the rectum. The stoma is
typically located on the lower left quadrant of the abdomen, and the output is formed.
An ileostomy is a surgical opening created in the ileum to bypass the entire large intestine. A
procedure used to treat colon cancer and ulcerative colitis, total proctocolectomy, involves surgical
removal of the entire colon, rectum, and anus, with closure of the anus, resulting in the need for
stool diversion.
As part of the total proctocolectomy procedure,
1. The end of the terminal ileum is brought out through the abdominal wall, forming a permanent
ileostomy.
2. After this type of ileostomy surgery, the patient has no voluntary control of bowel movements.
3. The stoma of an ileostomy is typically located in the right lower quadrant.
A restorative proctocolectomy with IPAA (ileal pouch anal anastomosis) involves connecting the
ileum to a "new" rectum (or anal pouch),
also made out of a portion of ileum; it is the procedure of choice in cases where the rectum can be
preserved, allowing the patient to retain anal sphincter control of bowel movements. The patient
will have a temporary loop ileostomy to divert stool while this new anal pouch heals, followed by
closure of the ostomy a few months later.
An alternative to the standard ileostomy
is Kock's continent ileostomy. During the procedure, an internal pouch is created from the distal
segment of the ileum, which serves as a reservoir for stool.
-During surgery, a one-way nipple valve is constructed through the stomal opening so that
eventually the patient can insert a catheter through the stoma and through the one-way valve to
drain the fecal contents of the internal pouch.
-This type of ostomy is occasionally created to treat ulcerative colitis and may be an option for
patients who do not wish to wear an external pouch over the stoma. However, the complication rate
associated with a continent ileostomy is usually higher than with a traditional ileostomy. The patient
empties the pouch several times a day and the stoma is covered with a protective dressing or a
stoma cap.
.
the complication rate associated with a continent ileostomy is usually higher than with a traditional
ileostomy.
.
