You need to do an in-service for a group of new employees on the surgical unit. They have no idea about colostomies and the different types or what they are used for
a. Describe the different types of colostomies and the different areas of the bowels they may be placed.
b. What is monitored?
c. What teaching education should you consider?
Students' answers should include the following:
a. Single barrel has a single stoma where fecal matter passes through.
Double barrel, usually transverse section of large intestine; proximal and distal end are brought through the skin.
Distal end does not pass feces, only mucus.
Double barrel is usually temporary and usually resected together at a later date.
Loop colostomy has a portion of the bowel looped out over a rod on top of abdomen and then opened 24 to 72 hours after initial surgery.
Stoma is formed, and temporary pouch is used to receive feces.
b. Monitor V/S, LOC, neurologic status, I&O, pain, drainage, and gastric secretions from NGT.
c. Colostomy and ostomy teaching needs to be done prior to discharge from hospital.
Body image and psychological issues need to be addressed.
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A) Are easy to construct B) Are analyzed in a straightforward manner C) Encourage in-depth responses D) Are not subject to response biases
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