WEB WOC Ostomy Care Exam Questions And Answers All Correct

WEB WOC Ostomy Care Exam Questions And Answers All Correct jejunostomy location - ANS LUQ *frequently not marked by the WOC nurse jejunostomy disease and procedure - ANS 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 - ANS *function begins in 24-48 hours *initially gas, then watery clear/green output (fluid and digestive enzymes) *output up to 2400 ml/day *empty pouch when 1/3 to 1/2 full jejunostomy complications - ANS *monitor for electrolyte imbalances and dehydration *size pouch correctly to prevent leakage *may need to change pouch every 2-3 days ileostomy location - ANS RUQ ileostomy disease and procedure - ANS 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 - ANS *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 - ANS *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 - ANS RUQ or LUQ transverse colostomy disease and procedure - ANS 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 - ANS *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 - ANS *waistline location can be difficult to manage descending colostomy location - ANS LLQ descending colostomy disease and procedure - ANS 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 - ANS *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 - ANS *monitor, prevent, and manage constipation *may cause erectile dysfunction continent ileostomy (kock pouch) - ANS 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) - ANS usually done in 1, 2, or 3 stages t