ATI Ostomy Care

ATI Ostomy Care

Adhesives
material used to attach two objects or surfaces, such as glue
Allergic contact dermatitis
inflammation of the skin resulting from contact with an allergen
Anastomosis
formation of a connection between two usually distinct structures or portions of a structure
Cecostomy
surgical creation of an opening from the beginning of the large intestine (cecum) to the abdominal wall
Clip
closing advice
Cohesion
ability of the skin barrier to maintain its integrity when exposed to moisture
Colostomy
surgically created opening (stoma) from the colon (large intestine) to the abdominal wall to allow stool to pass out of the body
Conduit
passageway
Convex inserts
plastic discs that curve outward and are inserted inside the flange of some two-piece ostomy systems
Cystectomy
excision or resection of the bladder
Denudation
stripping of a body part or skin surface
Filtered pouch
ostomy output collection bag that incorporates an odor filtration apparatus
Flange
rim used for attachment to another object, such as an ostomy pouch
Flatus
gas or air generated in the stomach and/or intestines and expelled via the anus or an intestinal ostomy
Hartmann procedure
common temporary colostomy surgery that involves leaving the distal portion of the colon in place and oversewn for closure to create a Hartmann’s pouch
Hydrocolloid
substance that forms a gel with water and is used in some ostomy products to absorb perspiration and other metabolic secretions while preventing fungal and bacterial invasion
Hydronephrosis
enlargement of the kidneys as urine collects in the renal pelvis and kidney tissue
Hyperplasia
abnormal increase in the volume of a tissue or organ
Ileal conduit
surgical removal of a section at the end of the small bowel (ileum) and relocation as a passageway for urine from the kidneys to the outside of the body through a stoma
Ileostomy
surgical opening created in the ileum to bypass the entire large intestine
Irritant dermatitis
inflammation of the skin resulting from contact with an irritating substance
Kock’s pouch
internal pouch created from the distal segment of the ileum to serve as a reservoir for stool or urine
Luminal bleeding
blood seeping through the opening (lumen) of a stoma
Maceration
softening or dissolution of tissue after lengthy exposure to fluid
Mucocutaneous detachment
separation of the stoma from the peristomal skin; also called mucocutaneous separation
Mucocutaneous separation
separation of the stoma from the peristomal skin; also called mucocutaneous detachment
Peristomal skin
skin surrounding an ostomy
Peristomal retraction
pulling in of the skin around a stoma when the stoma when the stoma is drawn inward below skin level
Polymers
heat-sensitive chemical compounds, usually of high molecular weight, formed by combination of simpler molecules and used to fill in the creases and crevices of the skin’s surface to create a larger surface area for ostomy adhesion
Pouching system
one-piece or two-piece device that includes a skin barrier/wafer and a collection pouch for the diverted output, either stool or urine
Pressure ulcer
impaired skin integrity and/or formation of a wound due to prolonged pressure
Psoriasis
any of several related chronic, recurrent skin disorders
Refitting
adjusting a pouching system to accommodate changes in stoma size or to address other stomal or peristomal issues
Reservoir
storage place
Sigmoid
referring to the portion of the large intestine between the descending colon and the rectum
Skin barrier
faceplate designed to protect the peristomal skin from the stoma output and to which the pouch is attached
Skin stripping
mechanical disruption of the outermost surface layer of the epidermis, as can be caused by adhesives when an ostomy appliance is removed
Stoma
opening of the ostomy
Stomal height
degree of protrusion of a stoma from the skin
Stomal prolapse
lengthening of a stoma due to the bowel telescoping out through the stoma
Stomal retraction
pulling back of a stoma below skin level
Stomal stenosis
narrowing of the lumen of the stoma
Tackifiers
pressure-sensitve “glue” that must come into incomplete contact with the skin to adhere
Tap
device on a urostomy pouch that permits drainage of the contents
Ureter
narrow tubular duct that transports urine from the kidney to the bladder
Ureterostomy
surgically created opening that diverts urine away from a ureter and out of the body
Urostomy
surgically created opening that diverts urine away from a bladder and out of the body
Valsalva maneuver
forceful exhalation against a closed glottis, which involves contraction of the abdominal muscles to propel feces out of the body
Wafer
faceplate or barrier designed to protect the peristomal skin from the stoma output and to which the pouch is attached
A nurse is providing preoperative teaching for an older adult patient who has diverticulitis and is scheduled for a creation of a double-barrel colostomy in the sigmoid colon. Which of the following instructions should the nurse include in the teaching?
Tape a dry gauze pad over the distal stoma to collect drainage
While a nurse is teaching a patient how to replace her ostomy pouching system, the patient reports that removing the skin barrier is sometimes painful. Which of the following should the nurse suggest?
Push the skin away from the barrier while removing it
A nurse is replacing the ostomy appliance for a patient whose newly created colostomy is functioning. After removing the pouch, which of the following should the nurse do first?
Cleanse the stoma and the peristomal skin
A nurse is obtaining health history from a young adult patient who has a colostomy. The patient reports frequent episodes of loose stools over the last month, but has no signs of infection or bowel obstruction. He reports that his concerns about leakage have limited his social activities. Which of the following should the nurse recommend?
Consume foods that are low in fiber content
A nurse is teaching a patient with a new ileostomy about incorporating preventive strategies at home. To prevent excoriation and breakdown of the peristomal skin, the nurse should instruct the patient to
empty the pouch when it is no more than half full
A nurse is teaching a patient how to apply an extended-wear skin barrier. Which of the following strategies should the nurse instruct the patient to use for maximal adherence?
press gently around the barrier for 1 to 2 minutes
A nurse is providing preoperative teaching for a patient who has colon cancer. The surgeon informed the patient that his entire large intestine and rectum will be removed. The nurse should explain the type of ostomy he will have is
an ileostomy
A patient who has bladder cancer tells the nurse that, of the various urinary diversion options the surgeon presented, she prefers one that will allow her to have some control over urinary elimination. The nurse should explain the option that will allow that is
a Kock’s pouch