©THEBRIGHT EXAM STUDY SOLUTIONS 8/21/2024 8:36 PM
Ostomy care ATI Exam Questions
With Correct Answers
An ostomy is an opening - answer✔✔surgically created in the abdominal wall to allow for the
elimination of urine or feces.
Ostomy surgery is performed - answer✔✔when a disorder or an injury keeps the urinary or
gastrointestinal system from functioning properly.
Indications for ostomy surgery include: - answer✔✔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: -
answer✔✔colostomy
ileostomy
urostomy
The surgically-created opening in the skin of the abdomen is called a - answer✔✔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: -
answer✔✔1. End ( Hartmans pouch)
2. Loop
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3. Double barrel
With an end colostomy, t - answer✔✔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 - answer✔✔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, - answer✔✔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 - answer✔✔
With a double-barrel colostomy, - answer✔✔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: - answer✔✔1. Ascending colon
2. Transvers colon
3. Descending Colon
4. Sigmoid Colon.
Ascending colon (right abdomen). - answer✔✔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. - answer✔✔output- liquid to semiformed
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Descending colon (left upper abdomen). - answer✔✔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 - answer✔✔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. - answer✔✔
As part of the total proctocolectomy procedure, - answer✔✔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), - answer✔✔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 - answer✔✔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.
