Stoma Care

Question 1

What is an otostomy?

Answer 1

Brining an internal organ to the surface

Question 2

Examples of ostomys?

Answer 2

• colostomy
• Ileostomy
• urostomy & uresterostomy

Question 3

Colostomy?

Answer 3

Formed from the large bowel
Output: formed and soft

Question 4

Ileostomy?

Answer 4

• formed from ilium
• output: lose (porridge consistency)

Question 5

Urostomy?

Answer 5

Ureters are attached, urine flows from the bladder to stoma

Urine output: urine will contain mucus

Question 6

Why may someone need a stoma?

Answer 6

• IBD
• diverticulitis
• incontinence
• congenial
• carcinoma

Question 7

What problems can stoma cause?

Answer 7

Managing
Physiological
• low self-esteem/confidence
Skin problems
• fungal irritation
• abcess
• due to poor stoma care

Question 8

Dietary advice for colostomy

Answer 8

• no diet restrictions
• 8-10 cups of water/day

To avoid constipation:
• adequate water intake
• increase fibre intake
• fruit & veg

Question 9

Dietary advice for Ileostomy?

Answer 9

• 8-10 cups of water/day
• avoid spicy food - diarrhoea
• avoid too much fibre (nuts, fried fruit, sweetcorn)

Question 10

Diet to avoid?

Answer 10

Veg and fruit which has bad odour
-radish, garlic, cabbage
Fizzy drinks
Chewing gum
High-mod fibre diet

Question 11

What is the normal volume of stoma output per day

Answer 11

400-800ml/day

Question 12

If patients out out is too little/too much, how can this be controlled?

Answer 12

Meds which can cause constipation:
• antacid - aluminium
• iron tablets

Meds which can cause diarrhoea:
• antacids - magnesium salts
• iron tablets
• antibiotics (macroildes)

Question 13

Ideally stoma output should be less than?

Answer 13

1000ml/day

Question 14

Which medication are used to reduce high stoma output?

Answer 14

Antimotility -
• loperamide + codeine

Antisecretory
• omeprazole (due to high secretion of HCl )

Fluid replacement - (avoid hypotonic fluid)
• give oral rehydration

Nutrition (lack of nutrient absorption)
• vit B deficiency - give thiamine
• hypomagnesia
• hypophosphtamia

Question 15

How are ABSORPTION of medications affected in stoma patients?

Answer 15

• enteric coated tablet + coated tablet - are not absorbed at the site long enough
• laxatives - decrease absorption time
• levothyroxine needs an acidic environment to be absorbed - PPIs can affect this

Question 16

How is the DISTRIBUTION of medication affected in stoma patients?

Answer 16

If stoma output is high - there is reduced distribution for water soluble drugs

Question 17

How is the METABOLISM of medication affected in stoma patients?

Answer 17

Malnourished patient - less absorption of proteins

Protein is required for - enzyme drug metabolism

Question 18

How is the EXCRETION of medication affected in stoma patients?

Answer 18

• dehydrated patients have reduced renal function
• reduced renal function = reduced clearance of drugs

Question 19

Which painkillers are prescribed in Stoma patients?

Answer 19

Non opioid - paracetamol

If NSAID - monitor- due to increase risk of bleeding