You have a patient with a sigmoid colostomy who developed stomal stenosis 8
weeks postoperatively. What is the key factor that increased your patient's risk
for developing this complication?
Select one:
a. A stomal necrosis.
b. A stomal prolapse.
c. A significant recent weight loss.
d. Performing sit-ups. - ANSWERS-a. A stomal necrosis.
You have a 4-year-old child that needs his low-profile gastrostomy tube replaced.
What step would be MOST important when performing this procedure?
Select one:
a. Have parents give pain medication prior to procedure.
b. Cleanse the skin with soap & water.
c. Measure the length of the stoma tract with a measuring device.
d. Use sterile gloves. - ANSWERS-c. Measure the length of the stoma tract with a
measuring device.
,Mrs. Owens arrives in your Ostomy Clinic complaining that the pouch leaks within
a few hours even though she puts it on exactly how she was instructed. The
stoma protrudes 2 cm and her abdomen is soft; she is slightly overweight. Which
of the following steps is essential to assure proper fitting of her ostomy pouch?
Select one:
a. Use a skin cement to increase the adherence of the pouch.
b. Assess her abdominal topography and stoma with her in the sitting position
and standing position.
c. Trim the skin barrier to be 1/4 inch larger than the stoma.
d. Instruct her to begin using a belt. - ANSWERS-b. Assess her abdominal
topography and stoma with her in the sitting position and standing position.
Vinegar soaks to the stoma is an appropriate intervention to reduce or remove:
Select one:
a. Peyer's patches on the mucosa.
b. Urine odor.
c. Encrustations.
d. Caput Medusa. - ANSWERS-c. Encrustations.
Of the following individuals, who is MOST at risk for developing a stomal
prolapse?
,Select one:
a. Infant with a loop transverse colostomy.
b. 20-year-old male with a temporary loop ileostomy.
c. 65-year-old male with an end sigmoid colostomy and significant ascites.
d. 55-year-old female with a transverse double barrel colostomy. - ANSWERS-a.
Infant with a loop transverse colostomy.
Ms. Anderson has a diagnosis of Caput Medusae in the WOC Nursing chart. You
would expect to see protuberant veins in the peristomal field which are caused
by:
Select one:
a. Chronic exposure to effluent.
b. Portal hypertension.
c. Stomal prolapse.
d. Parastomal hernia. - ANSWERS-b. Portal hypertension.
An incarcerated bowel is an emergent complication associated with:
Select one:
a. Mucocutaneous separation.
b. Stomal stenosis.
c. Parastomal hernia.
, d. Peristomal pyoderma granulosum. - ANSWERS-c. Parastomal hernia.
A 28-year-old female has a permanent ileostomy and you notice ulceration at 9
o'clock in the peristomal area 7 mm from the base of the stoma. The ulcer is
producing fecal material. Without knowing her history, what is this describing?
Select one:
a. Candidiasis due to steroids.
b. Familial adenomatous polyposis.
c. Peristomal pyoderma gangrenosum.
d. Enterocutaneous fistula - ANSWERS-d. Enterocutaneous fistula
The most effective pouching technique for the patient with an ileostomy and a
small fistula open on the skin about 5mm from the base of the stoma is to:
Select one:
a. Cover the fistula opening with a skin barrier paste and pouch over the fistula
opening.
b. Apply a skin barrier powder into the fistula track to absorb drainage and pouch
over the fistula opening.
c. Resize the stoma opening in the pouch to include the fistula opening.
d. Place a catheter into the fistula opening, feed the catheter through the stoma
opening on the pouch and anchor the catheter to the front of the pouch. -
ANSWERS-c. Resize the stoma opening in the pouch to include the fistula opening.
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