WEB WOC Ostomy Care question with
answers
jejunostomy location - -LUQ
*frequently not marked by the WOC nurse
-jejunostomy disease and procedure - -ischemic 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 - -*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 - -*monitor for electrolyte imbalances and dehydration
*size pouch correctly to prevent leakage
*may need to change pouch every 2-3 days
-ileostomy location - -RUQ
-ileostomy disease and procedure - -crohn'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 - -*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 - -*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 - -RUQ or LUQ
-transverse colostomy disease and procedure - -diverticulitis, 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
, -transverse colostomy function and management - -*function begins within 48
hours
*initially gas, then mushy or semi-formed
*may have urge to poop with mucous from rectum
*no effect on nutritional absorption
-transverse colostomy complications - -*waistline location can be difficult to
manage
-descending colostomy location - -LLQ
-descending colostomy disease and procedure - -colorectal cancer, trauma, bowel
perforation, ischemic bowel
permanent end colostomy with rectum and anus removed, temporary or permanent
end colostomy with Hartmann's pouch (sewing shut top of rectum with ability to
reconnect to GI tract later)
-descending colostomy function and management - -*function may not begin for up
to 5 days post-op
*initially gas, then liquid, then semi-formed to formed
*odor and gas of concern due to higher amounts of bacteria
*may need colostomy irrigation routinely
-descending colostomy complications - -*monitor, prevent, and manage
constipation
*may cause erectile dysfunction
-continent ileostomy (kock pouch) - -total proctocolectomy performed and
abdominal ileal pouch is made. The continence mechanism is a nipple valve
constructed in the pouch by intussusception.
-ileal pouch anal anastomosis (IPAA) - -usually done in 1, 2, or 3 stages
the colon and most of the rectum are removed, but the anus remains intact, a
pouch is constructed from the ileum and anastomosed to the distal rectum, a
temporary loop ileostomy is created to divert stool while the anastomosis heals, the
ileostomy is taken down once the suture lines heal and normal bowel function is
restored
-ileal/colon conduit location - -ileal: RLQ
colon: LLQ
-ileal/colon conduit disease and procedure - -bladder 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
answers
jejunostomy location - -LUQ
*frequently not marked by the WOC nurse
-jejunostomy disease and procedure - -ischemic 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 - -*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 - -*monitor for electrolyte imbalances and dehydration
*size pouch correctly to prevent leakage
*may need to change pouch every 2-3 days
-ileostomy location - -RUQ
-ileostomy disease and procedure - -crohn'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 - -*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 - -*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 - -RUQ or LUQ
-transverse colostomy disease and procedure - -diverticulitis, 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
, -transverse colostomy function and management - -*function begins within 48
hours
*initially gas, then mushy or semi-formed
*may have urge to poop with mucous from rectum
*no effect on nutritional absorption
-transverse colostomy complications - -*waistline location can be difficult to
manage
-descending colostomy location - -LLQ
-descending colostomy disease and procedure - -colorectal cancer, trauma, bowel
perforation, ischemic bowel
permanent end colostomy with rectum and anus removed, temporary or permanent
end colostomy with Hartmann's pouch (sewing shut top of rectum with ability to
reconnect to GI tract later)
-descending colostomy function and management - -*function may not begin for up
to 5 days post-op
*initially gas, then liquid, then semi-formed to formed
*odor and gas of concern due to higher amounts of bacteria
*may need colostomy irrigation routinely
-descending colostomy complications - -*monitor, prevent, and manage
constipation
*may cause erectile dysfunction
-continent ileostomy (kock pouch) - -total proctocolectomy performed and
abdominal ileal pouch is made. The continence mechanism is a nipple valve
constructed in the pouch by intussusception.
-ileal pouch anal anastomosis (IPAA) - -usually done in 1, 2, or 3 stages
the colon and most of the rectum are removed, but the anus remains intact, a
pouch is constructed from the ileum and anastomosed to the distal rectum, a
temporary loop ileostomy is created to divert stool while the anastomosis heals, the
ileostomy is taken down once the suture lines heal and normal bowel function is
restored
-ileal/colon conduit location - -ileal: RLQ
colon: LLQ
-ileal/colon conduit disease and procedure - -bladder 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
