Ostomy Final Study Guide (2022/2023) (Verified Answers)

Ostomy Final Study Guide (2022/2023) (Verified Answers) A patient with a newly created continent urinary reservoir requires self-care education prior to discharge. Which of the following would explain the purpose for ...

Ostomy Final Study Guide (2022/2023) (Verified Answers) A patient with a newly created continent urinary reservoir requires self-care education prior to discharge. Which of the following would explain the purpose for maintaining a secured catheter in the reservoir? ✔✔Decompress the reservoir. The WOC nurse is instructing a patient on safe and effective use of an ostomy belt. Which response is most accurate? ✔✔The belt should fit snugly against the abdomen. When teaching ostomy care to a 12 year old child, which of the following should be stressed? ✔✔Keep extra pouching supplies. A 16 year old female had the first stage of an ileal pouch anal anastomosis (IPAA) procedure 3 weeks ago. She calls the nurse to report that there has been no ileostomy output for 12 hours. She now has abdominal pain and nausea with vomiting. She describes a pain level of 5 on a pain scale of 0-10. Her last meal on the previous evening included a pizza with sausage and mushrooms, a banana, and a soda. Which of the following should the nruse advise? ✔✔Proceed to the ER for a flat plate and ileal lavage. A patient with intractable UC is on high-dose corticosteroids. After a total proctocolectomy with ileostomy, which of the following complications should be anticipated? ✔✔Mucocutaneous separation. Proper management of peristomal skin should include. ✔✔Cleansing the skin with warm water. When teaching ostomy self-care to an elderly patient, which of the following techniques works best? ✔✔Frequent, brief teaching sessions. Which of the following is a symptom of stomal stenosis. ✔✔Narrow caliber of stool. A female patient is 6 weeks post-operative abdominal perineal resection. She expresses interest in resuming sexual activity What suggestions could the WOC nurse? ✔✔Use attractive pouch cover. On instructing a patient with an ileostomy on the best diet approaches, which of the following foods should the patient be taught to avoid? ✔✔Chinese vegetables, corn, kimchi, and nuts. A 9 year old with an ostomy is starting the new school year. Which of the following would be the expectation while she is at school? ✔✔Be independent with ostomy care. A patient with an ECF located in a closed abdominal incision has irritant dermatitis of the perifistular skin and a small amount of malodorous thick effluent. The most appropriate management for this patient should include which of the following? ✔✔Use skin barrier and apply a pouching system. A patient had a sigmoid bowel resection. Which of the following types of temporary diversions is recommended for protection of the distal anastomosis? ✔✔Loop ileostomy. A patient with an ileostomy returns to the outpatient clinic for the first post-op visit. On removal of the pouching system, the peristomal skin is inflamed and eroded. This condition is known as which of the following? ✔✔Peristomal MASD. A person with an ileostomy is likely to have difficulty absorbing which type of medication? ✔✔Enteric coated tablets. Which of the following is appropriate management of peristomal MASD? ✔✔Modify the pouching system to obtain an effective seal. A patient with an ileostomy presents with symptoms of lethargy, muscle cramps, dry mouth, and decreased urine output. What would be the best WOC nurse action? ✔✔Obtain LIP order for serum electrolyte level. Proper management of peristomal skin should include which of the following? ✔✔Cleanse peristomal skin with warm water. Removal of part of the terminal ileum results in decreased absorption of which of the following nutrients? ✔✔Vitamin B12 and bile salts. A 2 year old child can best be prepared for ostomy surgery by using which of the following methods? ✔✔Play therapy for the child while the parents are present. The WOC nurse is providing instruction to a patient with a new ileal conduit. Which of the following symptoms indicates the need for the patient to seek urgent medical care? ✔✔Fever, chills, and retroperitoneal pain. Two years after successful ileal pouch anal anastomosis surgery, patients should be instructed to expect how many BMs per day? ✔✔4-8. Which of the following patients would be the best candidate for teaching colostomy irrigation? ✔✔A person with descending end colostomy with 2 or less formed BMs per day. A patient with a peristomal hernia presents to the outpatient clinic complaining of pouch leakage. Which pouching solution would be best? ✔✔A flexible pouching system. A patient has been irrigating her sigmoid colostomy on a daily basis and is having increased difficult instilling the water. Which of the following is the most likely cause? ✔✔Peristomal hernia. A 30 year old woman with an ileostomy routinely changes her 2 piece pouching system every 5 days. She is 26 weeks pregnant and calls the nurse to complain of daily pouch leakage. What is the best intervention for this situation? ✔✔A flat, 1 piece, cut to fit, drainable pouch. Which of the following patient situations should be monitored for pernicious anemia? ✔✔Ileostomy. For which of the following peristomal skin conditions would be an antifungal powder be the most effective? ✔✔Candidias. Which of the following is the most important aspect of a teaching protocol for a patient with biliary tube? ✔✔Stabilizing and flushing the tube. The critical consideration for a stoma site mark is which of the following? ✔✔Flat pouching surface. What is the best method to adminster meds via PEG tube? ✔✔Flush with 10ml of water before/after each med. An infant diagnosed with myelomeningocele would be expected to have which of the following surgical diversions? ✔✔Vesicostomy. Stomas are matured (everted) at the time of surgery to prevent which of the following complications? ✔✔Serositis. Which form of medication is most appropriate for a patient with an ileostomy? ✔✔Liquid. An essential component of patient education after the second stage of a 2 stage ileal pouch anal anastomosis is which of the following? ✔✔Use moisturized cleansing pads after each BM. A female patient will undergo anterior pelvic exenteration surgery. What type of stoma will the WOC nurse need to prepare the patient for? ✔✔Indiana pouch. The WOC nurse should assess the person with a new ostomy for which of the following psychosocial factors? ✔✔Assess for coping skills prior to ostomy surgery. Which of the following demonstrates appropriate use of products in the nursing management of fistula? ✔✔Pouching system for high or low output fistula. A patient has been successfully irrigating his colostomy, but is now experiencing diarrhea as a result of cancer treatment. Which of the following is the best approach? ✔✔Discontinue irrigation. A patient with rectal cancer staged T3, N0, MO would be treated with what therapy type? ✔✔Adjuvant chemotherapy and radiation. A neobladder, also called orthotopic urinary diversion, is created from which of the following bowel segments? ✔✔Ileum only. For which patient would a high volume output pouch be most appropriate? ✔✔Liquid stool over 1200ml in 24h. A patient returns to the outpatient clinic 3 weeks following construction of an Indiana pouch. The WOC nurse will educate the patient on time of self-cath intervals. Which is the best approach? ✔✔Self-cath q2h for 1 week, q3h for weeks 2-3, q4h after that. A patient is having difficulty maintain a pouch seal for more than 24h. In assessing the situation, the WOC nurse notes saucering around the stoma while the patient is in a sitting position. The patient's abdomen is soft to palpation. What shape of skin barrier should the WOC nurse recommend? ✔✔Firm convexity. A patient a high output ECF. Which of the following meds could be used in an attempt to lower the output? ✔✔Octreotide acetate (Sandostatin). Which of the following disease features distinguish Crohn's disease from UC? ✔✔Granulomas and patching, full thickness intestinal wall involvement. In teaching the bedside nurse on how to change the fistula pouch, which of the following is a recommended step in this procedure? ✔✔Trace the pattern onto the skin barrier surface of the pouching leaving at least 1/4 inch clearance. A patient with GERD requires enteral feedings. Which procedure is most likely to be done? ✔✔Percutaneous gastrojejunal tube. A patient undergoing radiotherapy for rectal cancer care develops diarrhea. The WOC nurse is consulted for skin care recommendations. Which is the best approach? ✔✔Use of a water miscible ointment for skin protection. A patient with a sigmoid colostomy calls the WOC nurse to report the water used for irrigation has not returned, and has no other complaints. The patient should be instructed to do which of the following? ✔✔Increase fluid intake as the patient may be dehydrated. Which of the following is the reason for placement of ureteral stents during ileal conduit surgery? ✔✔Protect the anastomotic site. In a patient with an ileal conduit, symptoms of a UTI would include which of the following? ✔✔Fever, chills, and flank pain. A patient with a g-tube is experiencing irritant dermatitis in the peritubular skin. Which intervention best addresses the problem? ✔✔Stabilize the g-tube. A patient reports that her pouching system began leaking after starting chemo. The patient's peristomal skin should be assessed for which of the following? ✔✔Fungal infection. A person with an ileostomy will have difficult in absorbing which type of medication? ✔✔Time released cold tablets. A 17 year old patient had ileostomy surgery 8 weeks ago. At the follow up visit, the patient states his mother is changing the pouching system. What is the best response? ✔✔What is keeping you from taking care of your own stoma? A mother bring her 2 month old child for a follow up ostomy assessment. The stoma is prolapsed, and a small laceration is noted on the mucosa near the base of the stoma. What is the best approach? ✔✔Remeasure the stoma for correct pouch size and instruct mother to cut radial slits into the pouch aperture. Which of the following terms describes a fistula between the bladder and the skin? ✔✔Vesicocutaneous.