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Urinary diversion
Urinary diversion articles
17
Nursing
Not Applicable
09/10/2013

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Cards

Term
what is urinary diversion
Definition
diverting urine out of the body using ana lternative pathway --> can be either continent or incontinent
Term
patients with an incontinent diversion must always? ...
Definition
wear a pouch to collect urine
Term
how is the bowel used in incontinent diversion?
Definition
the bowel is used to create a stoma and ureters are implanted in the bowel. smaller lengths are required for incontinent diversion than are for continent diversion and less surgical time is involved
Term
How is bowel used in continent urinary diversion?
Definition
in continent diversion, the bowel is used to create a reservoir that can store urine. Ureters are attached to the reservoir and a catherizable stoma is created
Term
what is an ileal conduit
Definition
a common type of incontinent diversion created by removing a portion of the last segment of the ileum and reconnecting the rest of the small intestine so that everything continues function
Term
why does the surgeon try to preserve the last 12-15 cm of the ileum?
Definition
because that area is closest to the ileocecal valve and is important in the absorption of vitamin b12 and bile
Term

why must patients having a continent diversion have good renal function and healthy bowel?

 

Definition
because more of the bowel is required to create a continent urinary pouch
Term
the distal end of the resected ileum is...
Definition
used to create a stoma in the abdominal wall usually in rlq
Term
what are the ureters attached to in incontinent diversion
Definition
the other end of the ileum where the urine then travels through the conduit and exits the stoma in an external collection pouch
Term
why are ureteral stents placed?
Definition

to help maintain patency of the ureters and bowel

they are usually left in place 5-7 days with incontinent diverison; and 5-10 post op with continent diversion

Term
what lab values need to be monitored
Definition
CMP and CBC
Term
most common complications after incontinent diversion
Definition

stomal stenosis

prolapse

parastoma hernia

stomal retraction

Term
patients are at risk for ______? with both diversions
Definition
hyperchloremic metabolic acidosis with hypokalemia caused by prolonged contact of the urine with intestinal mucosa
Term
why are they at risk for this?
Definition
the intestinal mucosa is very absorptive which means that normally excreted sodium and chlorine in the urine are reabsorbed by the bowel wall and potassium and bicarb are excreted
Term
2 types of continent diversion
Definition

1. a diversion where a catheterizable stoma is created

2. where a neobladder or internal pouch is created

Term
complications related to continent diversion
Definition

difficulty catheterization or stricture formation

failure to cath at appropriaye intervals may cause pouch rupture (medical emergency)

A complication specific to the use of a colon as the resivoir is colon cancer

Term
a continent diversion with a neobladder
Definition
involves creating a new bladder from a portion of the ileum and colon that's located where the bladder used to be
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