Stoma Care Lecture Flashcards

A comprehensive set of practice questions covering stoma definitions, types of ostomies, appliance systems, maintenance procedures, and patient counseling regarding diet and medications.

What is the definition of an ostomy?

An ostomy refers to a surgical procedure in which an artificial opening, known as a stoma, is created in the abdominal wall. This procedure enables the diversion of bodily waste (stool or urine) from the digestive or urinary tract due to conditions such as cancer, trauma, or disease, providing a new pathway for waste elimination.

What is a stoma?

A stoma is the surgically created opening formed during an ostomy procedure. This opening connects the intestine or urinary tract to the outside of the abdomen, allowing for the passage of waste when the normal excretion pathways are compromised or removed.

What is an ileostomy?

An ileostomy is a specific type of ostomy in which a surgical opening is made from the ileum, which is the terminal portion of the small intestine. This procedure diverts waste away from the colon and rectum, allowing stool to exit through the stoma, often used in cases of inflammatory bowel disease or colorectal cancer.

What is the typical consistency and color of discharge from an ileostomy?

The discharge from an ileostomy typically appears as a dark green liquid to a semi-soft, stool-like consistency. This output is less odorous compared to colonic stool because it does not undergo fermentation in the colon, and the presence of digestive enzymes contributes to its liquid nature.

Contrast the discharge of an ascending colostomy versus a descending colostomy.

An ascending colostomy produces liquid to soft, unformed stool due to the shorter transit time and higher fluid content, while a descending colostomy yields semi-solid, formed stool as it allows for more water absorption, resembling normal bowel movements. The consistency depends on the location of the colostomy along the large intestine.

What is the purpose of a urostomy (urinary diversion)?

A urostomy is a surgical procedure designed to divert urine away from a diseased or dysfunctional bladder. This is typically accomplished by creating a stoma through which urine can exit the body, usually using a section of the intestine to form a conduit, effectively bypassing the bladder.

What is the difference between a one-piece and a two-piece pouching system?

In a one-piece pouching system, the ostomy pouch and adhesive base plate are integrated into a single unit, facilitating ease of use. Conversely, a two-piece system consists of a separate pouch and skin barrier (base plate) connected via a flange, allowing for convenient emptying of the pouch while leaving the barrier in place for longer wear.

When is a convex base plate indicated over a flat base plate?

A convex base plate is specifically indicated for stomas that protrude less than $1$ inch from the abdomen. This type of base plate exerts slight pressure on the stoma, enhancing its protrusion for better output management, whereas flat base plates are recommended for stomas that extend at least $1$ inch from the body.

What are the primary functions of skin barrier creams or fillers, such as Stomahesive paste?

Skin barrier creams and fillers, such as Stomahesive paste, have multiple essential functions: they protect the skin surrounding the stoma from irritation caused by bodily waste, create a seal to prevent leakage, and fill in uneven skin surfaces to support a secure fit for the ostomy appliance, minimizing the risk of skin damage.

What is the definition of an ostomy?

An ostomy is a surgical procedure characterized by:

• Creation of an artificial opening (stoma) in the abdominal wall.

• Used for diverting bodily waste (stool or urine) when natural pathways are compromised due to conditions like cancer or trauma.

• Provides an alternative method for waste elimination when the typical digestive or urinary routes are impaired.

How should a stoma be measured when preparing a base plate?

To measure a stoma for a base plate accurately, use a stoma sizing guide to ensure the cut-out circle is approximately $1/8$ inch larger than the stoma. This allows for normal stoma swelling and avoids constriction, facilitating a comfortable and secure fit for the ostomy appliance.

According to the application guidelines, how long should you hold a base plate in place after pasting it over the stoma?

Following the application of a base plate over the stoma, it should be held in place for approximately $30$ seconds to $1$ minute. This duration ensures adequate adhesion, allowing for a reliable seal to prevent leakage, while ensuring proper skin contact.

What are the characteristics of a healthy stoma?

A healthy stoma is typically moist, vibrant red in color, and has a shiny appearance. These characteristics indicate good blood supply, appropriate healing, and proper functioning of the stoma, essential for effective waste elimination.

What are the general counseling points regarding the frequency of changing the base plate and emptying the bag?

It is advisable to change the ostomy base plate every $5$ to $7$ days, or earlier if there are signs of leakage or irritation. The ostomy pouch should be emptied when it is approximately $1/3$ full, or before bedtime, to avoid overflow and maintain skin health.

Which specific foods are mentioned as being likely to cause gas in ostomy patients?

Certain foods are known to potentially cause increased gas in ostomy patients, including asparagus, beans, beer, broccoli, cabbage, carbonated beverages, cauliflower, onions, peas, and high amounts of milk. This is due to their fermentation potential in the digestive process.

Which foods may cause a stoma blockage?

Specific foods that may lead to stoma blockage due to their texture or properties include nuts, seeds, popcorn, dried fruits like raisins, coconut, peas, corn, celery, and mushrooms. These foods can cause obstruction as they are either fibrous or too tough for the digestive system.

How does an ileostomy affect medication absorption?

Following an ileostomy, the route of medication absorption is altered as medications bypass the colon. This can significantly diminish the absorption of certain drugs, especially time-released (SR) or coated tablets, leading to reduced efficacy.

Which medication formulations are most suitable for patients with an ileostomy?

Patients with an ileostomy are best advised to use medication formulations such as solutions, suspensions, capsules, and uncoated tablets. These forms are preferable as they tend to be absorbed more effectively in the small intestine.

What is a specific caution for patients with a urostomy regarding medications?

While most medications can be absorbed without issue in urostomy patients, some, like Vitamin B, can alter the color and odor of urine, often producing a bright yellow color, which is important for patients to be aware of.

Why should soap be rinsed thoroughly from the skin around a stoma?

Thoroughly rinsing soap from the skin surrounding a stoma is crucial because soap residue can hinder the adhesion of the skin barrier, potentially leading to skin irritation or damage. This ensures the integrity of the stoma care routine.