Ostomy exam 2 Study Guide with complete solutions
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Ostomy exam 2 Study Guide with complete solutions
most common IPAA surgical plan
{{Ans- two stage
1) colectomy, subtotal proctectomy, create reservoir, anastomose; diverting loop ileo
2) ileo takedown
IPAA formation
{{Ans- terminal ileum
most commonly J pouch
usually stapled anastomosis UNLESS CA/dysplasia in remaining rectum
IPAA BMs
{{Ans- ileostomy-like
thick, mushy
long term frequency - 4-6/day
IPAA requirements
{{Ans- Dz limited to colon/prox rectum - UC, FAP (sometimes in Crohn's stable for years w/o SB involvement)
Good sphincters - usually manometry done
usually relatively slender - mobile mesentery
motivated - multiple surgeries, initial diarrhea, having ileostomy for a while
IPAA preop teaching
{{Ans- Ileostomy teaching - will be extra high volume d/t proximal, may empty at skin level
sphincter exercises when ileal-anal suture line healed
- instill increasing vol h20 and retain to increase capacity
- only after MD clearance
skin care - dimethicone, anorectal dressing pads, avoid irritants, may need to avoid acidic in diet
low insoluble fiber, eat before drinking, low fat
abscess at anastomotic site - purulent anal drainage
[Solved] Ostomy exam 2 Study Guide with complete solutions
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Ostomy exam 2 Study Guide with complete solutions
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