WEB WOC OSTOMY CARE Final Exam Review- Questions & Answers (Graded A+) |GUARANTEED PASS

WEB WOC OSTOMY CARE Final Exam Review- Questions & Answers (Graded A+) |GUARANTEED PASS orthotopic neobladder location - ANSWER -internal, no stoma orthotopic neobladder disease and procedure - ANSWER -early stage invasive bladder cancer the bladder is removed and an internal pouch is constructed from segment of ileum, pouch is located in the pelvis and attached to the urethra *continent urinary diversion = urine is emptied through the urethra like normal orthotopic neobladder function and management - ANSWER -*post-op similar to indiana pouch, will have Malecot catheter in place and removed once pt can empty bladder through urethra *will need pelvic flood muscle exercises *pt will need to perform valsalva while voiding *need to teach straight catheterization incase inability to empty bladder occurs orthotopic neobladder complications - ANSWER -*nocturnal enuresis *daytime incontinence (use routine voiding schedule) *bacteriuria *stones *pyelonephritis *pouchitis ureterostomy location - ANSWER -at anatomic location of ureter, between last rib and iliac crest ureterostomy disease and procedure - ANSWER -mega ureter right, left, or both ureters are brought to the skin surface and sutured in place, usually temporarily *pediatric procedure ureterostomy function and management - ANSWER -*functions immediately with clear or blood-tinged urine *stoma is flush to the skin and usually very small *difficult to pouch - diapering is more realistic option ureterostomy complications - ANSWER -*poor stoma management *pouching difficulties *stomal stenosis *pyelonephritis ureterosigmoidostomy locaiton - ANSWER -internal, no stoma ureterosigmoidostomy disease and procedure - ANSWER -bladder exstrophy, bladder cancer ureters are implanted into the sigmoid colon where urine is mixed with feces and expelled from anus *pediatric procedure ureterosigmoidostomy function and management - ANSWER -*unable to directly assess function *no stoma ureterosigmoidostomy complications - ANSWER -*malodorous stool *hyperchloremic acidosis *ureteral obstruction *pyelonephritis *frequent UTIs *frequent incontinence vesicostomy/ileovesicostomy/appendicovesicostomy location - ANSWER -just above the pubic bone (vesicostomy/leovesicostomy), or at the umbilicus (appendicovesicostomy) vesicostomy/ileovesicostomy/appendicovesicostomy disease and procedure - ANSWER -spina bifida, prune belly syndrome, bladder exstrophy vesicostomy: bladder is brought out to the skin ileovesicostomy: piece of bowel is used to form a channel from bladder to the skin appednicovesicostomy (mitrofanoff): appendix is used as the channel between the bladder and the skin, exiting at the umbilicus, continent stoma results *pediatric procedures vesicostomy/ileovesicostomy/appendicovesicostomy function and management - ANSWER -*functions immediately with clear to blood-tinged urine *diaper, catheterize, or pouching system vesicostomy/ileovesicostomy/appendicovesicostomy complications - ANSWER *UTIs *difficult to pouch given low location *high rates of wound infections *incontinence 3 major surgical procedures for colon and rectal cancer - ANSWER -1. colectomy without a stoma 2. low anterior resection with temporary stoma 3. abdominoperineal resection with permanent stoma low anterior resection - ANSWER -Resection of the lower colon and proximal rectum with an anastomosis of the remaining colon to the distal rectum *for tumors classified at the mid to high level of the rectum *2 stage procedure with temporary loop ileostomy