Colostomy care, Medicine adminstration

Question 1

ostomy

Answer 1

artificial opening in an organ of the body, created surgically

Question 2

Types of ostomies

Answer 2

colostomy (ascending, transverse, descending, sigmoid, loop); ileostomy; ureterostomy Consistency of stool and frequency of stool production depends on the ostomy location, diet, and hydration status.

Question 3

Transverse colostomy

Answer 3

This type of colostomy is located in the upper abdominal region, on the right side or the middle of the body. Transverse colostomies are usually performed on a temporary basis, but they may also be permanent.

Question 4

when is a transverse colostomy given

Answer 4

Doctors will choose a transverse colostomy if the lower half of the bowel needs a rest or to be permanently bypassed.

Question 5

Sigmoid colostomy

Answer 5

Located at the bottom of the large intestine, sigmoid colostomies are the most common. Because of its location near the rectum, there is still some functioning colon, so the waste produced is firmer and more normal in consistency than with other colostomy types. As with a descending colostomy, single-barrel is more common, though a double-barrel procedure is also a possibility. A loop-sigmoid colostomy is also a possibilit

Question 6

Descending colostomy

Answer 6

This surgery is performed when the blockage or cancer is located on the lower left side of the abdomen (or descending colon). In this surgery, the stoma placement results in waste close to normal in firmness because it’s already traveled through most of the colon.

Question 7

Ascending colostomy

Answer 7

Located on the right side of your abdomen, this type of colostomy is rare. During this procedure, most of your colon will likely be removed, so waste is liquid with this stoma

Question 8

mucous fistula

Answer 8

attaches a disconnected part of your intestine to a surgically created small opening in the skin on your belly (stoma). This connection helps people with certain bowel diseases pass mucous (intestinal secretions) out of the stoma instead of the anus.

Question 9

Hartmanns procedure

Answer 9

a type of colectomy that removes part of the colon and sometimes rectum The remaining rectum is sealed, creating what is known as Hartmann’s pouch. The remaining colon is redirected to a colostomy. It can be reversed later.

Question 10

Indications

Answer 10

Colon cancer
Bladder cancer
Invading gynecological or prostate cancer
Crohn’s disease
Ulcerative colitis
Diverticulitis
Bowel trauma

Question 11

Stoma

Answer 11

A stoma is an opening on the abdomen. It looks like a small, pinkish, circular piece of flesh sewn to your body. It may lie fairly flat on the body or protrude out.

Question 12

what foods should people with ostomies avoid

Answer 12

beans, cabbage, onions, and spicy foods. Some foods can cause cramping or may be difficult to pass through an ostomy if they are not chewed well. These include nuts, popcorn, and corn. Also, be aware of which foods may cause diarrhea or constipation. It is important that you stay hydrated, especially if you have an ileostomy, because stool is usually more watery.

Question 13

what medications work the best

Answer 13

liquid because they absorb faster

Question 14

when should you empty the ostomy bag

Answer 14

when it is less then half way 2/3

Question 15

what is a patient teaching about input and output

Answer 15

Learn how to plan your meals and fluid intake to cut down on the output of your ostomy ahead of a big or lengthy event. This may include a long work meeting or car or plane trip.

Question 16

Activities that they should be able to participate in

Answer 16

People with ostomies go to work, play sports, and engage in sexual activity. Reasonable activity will not hurt you or your stoma. Sweating may cause the tape that holds your pouch in place to loosen. If this happens, you might consider buying a specialized pouch for working out.

Question 16

What products should you avoid around ostomy

Answer 16

products that contain alcohol as they can cause dry skin. Do not use skin products made with oil. They will make it difficult for the pouch to stay attached

Question 17

what effects the output

Answer 17

Amounts of stool and gas that go into the pouch will vary based on the type of ostomy and your diet.

Question 18

When assessing the Stoma look at

Answer 18

size, shape, colour, edema, bleeding

Question 19

Abnormal stoma findings indicate

Answer 19

abnormal findings may indicate poor blood supply, obstruction, excessive tension, stomal trauma, GI bleeding, etc

Question 20

Peristomal skin skin should be free of

Answer 20

erythema, irritation, breakdown

Question 21

Does the stoma change during healing?

Answer 21

Size and shape of stoma will change as it heals, especially over the first 4-6 weeks

Question 22

what is a main goal of ostomy teaching

Answer 22

for them to be as independent as they can be

Question 23

The pouch needs to be

Answer 23

Personal capability
Security and proper fit
Stoma size changes
Closed or drainable
Skin stripping
Odor control
Skin excoriation
Changing timeline

Question 24

Ballooning

Answer 24

when their is gas in the ostomy bag

Question 25

Ischemia/Necrosis

Answer 25

loss of blood flow can cause death of tissue

Question 26

Retraction

Answer 26

when the stoma retracts

Question 27

Parastomal hernia

Answer 27

a type of incisional hernia that allows protrusion of abdominal contents through the abdominal wall defect created during ostomy formation

Question 28

Prolapse

Answer 28

occurs when your pelvic floor muscles are damaged or weakened to the point where they can no longer provide support.

Question 29

foods that tend to be more gassy include

Answer 29

beans, certain fruits (apples and pears), certain veggies (asparagus, broccoli, cauliflower, and carrots), dairy, grains, nuts, and carbonated beverages.

Question 29

10 rights of medication administration

Answer 29

Right medication
Right dose
Right time
Right route
Right client
Right reason
Right client education
Right documentation
Right to refuse
Right assessment/evaluation

Question 30

3 checks of med admin

Answer 30

Before you remove from the cupboard or medication cart
When you remove the drug from the container
After withdrawing the medication

Question 31

Right dose

Answer 31

May be unit dispensed from pharmacy
May be stocked in bulk
Is the dose a safe dose for your patient?
Is it the current order?
Calculations

Question 32

Calculation for dosage

Answer 32

desired dose/Availible dose x Vehicle =Amount

Question 33

Right time

Answer 33

Check time
Correct frequency
Confirm last dose given

Question 34

Right route

Answer 34

Enteral (Oral, Sublingual, Buccal, Gastrostomy Tubes)
Percutaneous (Topical)
Pulmonary (Inhalation)
Parenteral (Subcutaneous, Intramuscular, Intradermal, Intravenous)

Question 35

Oral medications include

Answer 35

Tablets
Scored tablets
Capsules
Enteric coated tablets
Time release capsules

Question 36

Liquid meds are for

Answer 36

Use for infants/children
Preferred over pills for enteral medication administration
If confused patients chew their medications
Swallowing issues
Thickened liquid diet

Question 37

Topical medication

Answer 37

Topical administration is the application of a drug directly to the surface of the skin

Question 38

Where can topical meds be administrated

Answer 38

eye vagina
nose urethra
ears colon

Question 39

Types of topical meds

Answer 39

Ointments
Creams
Lotions
Transdermal

Question 40

Inhalation meds include

Answer 40

Nebulizer
MDI

Question 41

Parental drug admin

Answer 41

Any drug administration outside of the GI tract
Typically, this route involves the use of needles
Medication is injected into the circulation or into tissues

Question 42

Right client

Answer 42

ID Band
Name
Personal identification number
Birth date
“What’s your name?”
LTC photo
Identified visually by staff who know them.

Question 43

where to check for Allergies

Answer 43

Check MAR
Ask patient
Look for Red ID band

Question 44

Right reason

Answer 44

What is the resident’s history?
Why is the resident taking this medication?
Should the resident still be taking it?

Question 45

Right education

Answer 45

Why are they receiving it?
What to expect?
Precautions?
Interactions (Drug-drug interactions/Drug-food interactions)
Adverse effects
Report changes
Recognize significant adverse effects

Question 46

Right to Refuse

Answer 46

If patient declines medication administration, inquire why client would like to decline a medication and document their reasoning.
If patient has questions about medication, explain possible therapeutic and adverse effects and purpose for administering this medication.
When taking medication history, be sure to ask specifics about dosage, frequency, route of administration, prescriber, and duration of use.
If medication order is unclear, contact original prescriber before administering medication.

Question 46

Right Documentation

Answer 46

MAR (Medication Administration Record)
Progress notes for exceptions to the routine and any PRN medications.
Special problems
New symptoms
Patient’s statements
Patient tolerance
Be sure to have the right chart
Be specific and accurate

Question 47

High Alert Medications

Answer 47

High-alert medications are drugs that have been identified as having a higher risk of significant patient harm if they are used in error.
-Look alike, sound alike