Term
Ileostomy:
Info & Considerations |
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Definition
Potential for food blockage - created higher in GI tract where lumen is smaller... chew food well, increase fluid intake, caution will slowly absorbed medications, protect peristomal skin
Stool usually liquid
NO laxatives or enemas
Call MD immediately if diarrhea & vomiting - can dehydrate quickly! |
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Term
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Definition
Stool usually semi-solid to solid
Usually NO dietary restrictions, but gas & odor can be a problem AND still possible to get consipated!
Rectal Cancer = #1 reason for permanent ostomy |
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Term
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Definition
Red & Moist, easy to bleed
NO feeling, DOES NOT HURT
Will shrink in first 1-2 months
NO sphincter, NO control |
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Term
Surgical Options:
Abdominal Perineal Resection [APR] |
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Definition
Removal of distal bowel(rectum & anus)
Formation of permanent stoma
Often done for rectal cancer
Will have rectal incision |
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Term
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Definition
| Resection of affected bowel, proximal bowel brought out to stoma and distal end is sewn closed & left in abdomen. Distal end of bowel will continue to produce mucus - patient will have urge to BM & will pass mucus rectally. |
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Term
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Definition
Resection of affected bowel: proximal end brought out as functioning colostomy/ileostomy and distal end brought out as "mucous fistula"(will produce mucus)
*Output confirms which stoma is proximal vs distal* |
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Term
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Definition
Loop of bowel is brought out through abdominal wall & stabilized with a rod to prevent retraction. Anterior wall of bowel is opened to allow elimination of stool
Usually Temporary
Rod can pose pouching problem |
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Term
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Definition
Small portion of small intestine/illeum is sectioned out to use as artificial bladder. Stents are used to keep ureters open while anastamosis heals.
Special Considerations: INCREASED RISK FOR UTI - call MD with any signs of infection!
Drink plenty of fluids to keep ileal conduit flushed, attach pouch to bedside drain at night to prevent overfilling of pouch. |
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Term
Ostomy Care:
General Guidelines |
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Definition
Stoma should be red & moist
Change pouch 1-2 times per week
Empty pouch when 1/3 full
Shower with pouch ON or OFF
Drink 8-10 cups of fluid per day
Call MD for changes in stoma, skin irritation, vomiting, abdominal swelling or cramping |
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Term
| Irritant Dermatitis [enzymatic] |
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Definition
| Caused by poor pouch seal/leakage, incorrect skin barrier size, poor stoma construction |
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Term
Colostomy Irrigation:
General Info |
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Definition
Cone enema in ostomy every 3 days - takes 30min-1hr each time
Works by distending color, mechanical stretch receptors in bowel wall cause peristalsis
Can use to regulate bowel movements so that pouch is not necessary
Can use as bowel prep prior to surgery or to remove barrium or dry stool |
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Term
Colostomy Irrigation:
Possible Complications |
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Definition
Vasovagal Reaction: loss of consciousness, ALWAYS make sure patient is will someone
Water DOES NOT return: ileus(post op), dehydration/thirsty large intestine
Cramping: water too cold or infused too fast |
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