ostomy
#NAME?
indications for ostomies
-congenital anomalies
-IBD: ulcerative colitis and crohn's
-familial polyposis
-cancer
-radiation damage
-pressure ulcers
-trauma
-obstruction
-necrotizing enterocolitis
-bladder loss or dysfunction
ileostomy
#NAME?
colostomy
-created by bringing a portion of the large bowel through the abdominal wall
-discharge may be semi-soft, paste-like, or formed, depending on the portion of bowel used
-ascending: retained but the rest of the large bowel is removed bypassed; stoma is usua
urinary diversion
#NAME?
complications of ostomies
#NAME?
effects of food on stoma output
#NAME?
goals of self-care of ostomies
#NAME?
general management approach of ostomies
#NAME?
pouching systems
ideal: leak-proof, odor-proof, comfortable, easily manipulated, inconspicuous, safe, as inexpensive as possible
one-piece system ostomy pouch
skin barrier and pouch are available in one piece, easy to apply
two-piece system ostomy pouch
skin barrier is separate from the pouch, generally more pliable and adaptable to different abdominal contours
drainable, high-output ostomy pouch
used when bowel regulation cannot be established; allow for easy and frequent emptying
close-end ostomy pouch
used by patients who have regulated colostomies, one or two formed BMs within 24 hrs, or routinely irrigate to remove output
urostomy
allow a constant output of urine and easy emptying through a narrow valve opening
fitting and application of pouch
#NAME?
wearing time
-pouch should be emptied when it is 1/3 - 1/2 full to prevent leakage
-one-piece, closed-end systems are removed and disposed of once or twice daily
-those that can be drained can be left in place as long as they are comfortable and there is no leakage
-t
ostomy accessories
#NAME?
belts
#NAME?
absorbent gel packets and flakes
#NAME?
skin barriers, powders, and pastes
#NAME?
precautions for medication use
-check the pouch for undissolved tablets or tablet fragments when taking solid oral medications; coated or SR preparations may pass through intestinal tract without being absorbed
-liquids or preparations that are crushed or chewed before swallowing are p
patient counseling for ostomy care
-monitor patient's management of the ostomy and counsel on special needs
-provide information regarding local and national ostomy support