Advanced procedures
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| show | Hemodialysis and peritonal dialysis
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| show | some type of disease process (ex bowel or diverticulitis), trauma to gi tract, congenital defect
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| show | injury or inflammation/disease
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| show | more serious things such as cancer or things that wont change
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| show | pts weight, anatomical land mark, scares, ease of access/self care
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| show | Ileostomy, continent (cough) iliostomy, ascending colostomy, transverse colostomy, descending/sigmoid colostomy
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| Ileostomy def | show 🗑
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| show | precaution for skin breakdown d/t digestive enzymes - make sure it fits properly; will have small amt of odor; nutrition and fluid and electrolyte balance
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| show | dont need drainage b/c its internal not external; have to empty cath at least 3-5 times per day; not option for everyone - only certain pts
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| show | middle or right side of anatomy; drainage still liquid - same as ileostomy - digestive enzymes in lg intestine but more odor and more temporary
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| Transverse colostomy def | show 🗑
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| Descending/Sigmoid portion of colon def | show 🗑
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| show | Loop ostomy, double barreled colostomy, single barreled/end. Loop and double barreled are temporary and single barreled/end is most common. Loop is least common
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| Loop ostomy def | show 🗑
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| Double barreled colostomy def | show 🗑
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| Single barreled/end | show 🗑
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| Nursing care for stoma | show 🗑
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| Observe drainage time span | show 🗑
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| Teaching ostomy care | show 🗑
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| show | body image change, lots of questions, avoid things that hard stoma, referral to support groups, encourage to verbalize fears
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| How long can appliances for ostomy be left in place? How much length can be left for sizing? | show 🗑
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| Urinary diversions def | show 🗑
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| show | malignancy of urinary tract, radiation damage to bladder, congenital or birth defects, trauma, obstruction, neurogenic bladder dysfunction, chronic UTI or pylonephritis
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| show | Nephrostomy tube, cystostomy, iloal conduit (brickers loop), cutaneous ureterostomy, ureterosigmoidostomy, vesicostomy, kock pouch
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| show | opening into kidney. permanent b/c of infection. temp for blockage. 2 sources of drainage. NI - sterile technique, sutures in place, monitor for obstruction, if clot gently push out, can irrigate w sterile solution max amt 5ml, hourly output for 1st 24 hr
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| show | same as suprapubic, into bladder, disadvantage - infection, temp, prostate/bladder surgery, NI - requires sterile technique, can be irrigated w/lg amts up to 200ml. if permanent skin seals leaving dressing off b/c of infection risk so clean on daily basis
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| Iloal conduit (Brickers loop) | show 🗑
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| Cutaneous ureterostomy | show 🗑
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| Ureterosigmoidostomy | show 🗑
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| show | attach bladder to abdominal wall and form stoma out of anterior wall. difficult to get good appliance b/c of clothing. temporary. easy to suture. continent diversion. pts cath themselves & dont have to wear appliance. urine stays in bladder until drained.
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| show | continent diversion. contain urine by taking section of ileum, pouch and urine stays in pouch until it comes out. cath every 4-6 hours can hold 100ml of urine. self cath w/ clean technique. not high risk for infection. permanent. limited # of pts
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| Nursing care for urinary diversions (5) | show 🗑
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| show | directed into ureter, placed by cystostomy & thread into ureter & splint opening. left in place for pts with kidney stones. forms innerlining and allows stones to pass. if external foley cath & stint run along side - need output
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| show | artifical semi-permeable membrane that acts like the kidney. Filter pts AB circulates while chemical waste & extra fluid are drawn out. Uses dialsyate solution going through dialyzer around fibers. Hard on cardiac system - shift in electrolyte balance
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| show | Diffusion & Ultrafiltration
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| show | fluid is drawn across semi-permeable membrane and goes from high hydrostatic pressure to lower. each pt has own prescription of dialysis.type, length of time (avg 4-5hrs), BF rate, dialsylate flow rate, dialsylate composition. 3 days/wk, consistent, life
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| show | 16 gauge; 6-8 weeks. check daily b/c its their life line
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| How do you check the patency of fistula? What are the 2 terms associated with it and their definitions | show 🗑
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| show | Continuous ambulatory peritonal dialysis (CAPD), Intermittent peritonal diaysls (IPD), Continuous cycling peritonal dialysis (CCPD)
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| CAPD | show 🗑
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| IPD | show 🗑
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| CCPD | show 🗑
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| show | Quick to be initiated - starts immediately, water exchange done much more gradual - not as hard on the cardiac system; not dependent on facilities
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| Nursing care for PD | show 🗑
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Created by:
breinard
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