Stoma Care (eBook)

Jennie Burch (Herausgeber)

eBook Download: PDF

2008
John Wiley & Sons (Verlag)
978-0-470-72214-5 (ISBN)

Infos

Stoma Care is a comprehensive and authoritative guide for all nurses and health care professionals with an interest in bowel conditions that may lead to stoma formation.

It explores the anatomy and physiology of the urinary and gastrointestinal system, and looks at topics including familial adenomatous polyposis, continence issues, nutrition, and conditions leading to stoma formation, complications, fistulae and intestinal failure. It also discusses the role of the nurse in surgery and in pre-and post-operative care.

Jennie Burch is a?Clinical Nurse Specialist at St Mark's Hospital, Harrow, UK.

Inhalt

Stoma Care 1
Contents 7
List of Contributors 16
Acknowledgements 19
Preface 20
Introduction 21
Chapter 1: Stomas: The Past, Present and Future 23
Introduction 23
The history of stomas 23
Stomas 25
Stoma care nursing 29
Roles of the stoma specialist nurse 30
Present day stoma care 31
Support groups 32
The future of stoma care 32
References 33
Chapter 2: Anatomy and Physiology of the Urinary and Gastrointestinal System 36
Introduction 36
The skin 36
Wound healing process 39
The abdominal wall 40
The peritoneum 41
The gastrointestinal tract 41
The digestive process 42
The bowel wall 43
Blood supply 44
Lymphatic supply 44
Mouth 45
Oesophagus 45
Stomach 45
Small intestine 47
Duodenum 47
Jejunum and ileum 47
Large intestine 49
Caecum 49
Ascending colon 50
Transverse colon 50
Descending colon 50
Sigmoid colon 50
Rectum 50
Anal canal 50
Accessory organs associated with the GI tract 51
The liver 51
The gallbladder 52
The pancreas 52
The spleen 53
Urinary system 53
References 57
Chapter 3: Colorectal Cancer and Adjunct Therapy 59
Introduction 59
Incidence 59
Possible causal factors 60
Symptoms and clinical presentations 62
Assessment, staging investigations and the multidisciplinary team 64
Multidisciplinary team 66
Pre-operative staging 66
Surgery 67
Histopathology 72
Adjuvant chemotherapy 73
Effects of chemotherapy on stomas 74
Radiotherapy 75
Palliative chemotherapy 75
Surveillance and follow-up 75
Screening 76
Conclusion 76
Further information and websites 76
References 77
Further reading 78
Chapter 4: Inflammatory Bowel Disease 80
Introduction 80
Crohn’s disease 80
Ulcerative colitis 80
Inflammatory bowel disease statistics 81
Signs and symptoms for ulcerative colitis 81
Crohn’s disease: signs and symptoms 82
Aetiology of IBD 83
Diagnosing IBD 84
Medical therapy for IBD 85
Dietary therapy for IBD 89
Surgery for Crohn’s disease 89
Surgery for ulcerative colitis 90
Malignancy in ulcerative colitis 91
Malignancy in Crohn’s disease 91
Extra-intestinal manifestations 91
Other medical issues in IBD 92
Fertility in IBD 92
Patient education 93
Conclusion 93
References 94
Chapter 5: Familial Adenomatous Polyposis 97
Introduction 97
The Polyposis Registry and research 97
Diagnosing FAP 98
Bowel screening of relatives ‘at-risk’ 100
Surgery 100
Colectomy with IRA 101
Restorative proctocolectomy 101
Total/panproctocolectomy 102
Upper GI disease 102
Extra-colonic manifestations (ECMs) 103
Desmoid disease 104
An accessible expert centre 105
References 107
Chapter 6: Continence 108
Introduction 108
Normal bladder and bowel control 108
Risk factors for incontinence 109
Obstetric trauma to the pelvic floor 109
Age 110
Investigations 111
Treatment of incontinence 112
Practical management 113
Surgical interventions 114
Conclusion 116
Useful websites 116
References 116
Chapter 7: Other Conditions Leading to Stoma Formation 118
Introduction 118
Congenital malformations/anomalies 118
Cystic fibrosis 119
Diverticular disease 120
Ehlers Danlos 120
Gynaecological tumour 120
Hereditary non-polyposis colon cancer (HNPCC) 120
Hirschsprung’s disease 121
Interstitial cystitis 121
Intussusception 121
Irradiation damage 122
Ischaemic bowel 122
Meconium ileus 122
Megarectum 122
Necrotising enterocolitis 123
Necrotising fasciitis 123
Obstruction 123
Perforated bowel 123
Solitary rectal ulcer 124
Spina bifida 124
Spinal cord injury 124
Trauma 124
Visceral myopathy 124
Volvulus 125
Conclusion 125
References 125
Chapter 8: Surgery 128
Introduction 128
Temporary stomas 128
Permanent stomas 129
Stoma formation 130
Surgical technique 131
Surgical alternatives 134
Complications 135
Enhanced recovery after surgery (ERAS) 138
Conclusion 139
References and further reading 139
Chapter 9: Pre- and Post-operative Care 141
Introduction 141
Referral to health care professionals 141
Pre-operative assessment and investigations 141
Pre-operative information 144
Bowel preparation 145
Meeting another ostomate 146
Informed consent 146
Stoma siting assessment 147
Cultural/religious issues related to siting 149
Stoma siting 149
Pre-operative fasting 150
Post-operative aims 150
Post-operative care 151
Blood tests 152
Nausea and vomiting 152
Nutrition 153
Post-operative analgesia 153
Post-operative exercises 155
Post-operative appliances 155
Post-operative stoma assessment 155
Normal stomas 156
Normal stoma outputs 156
Post-operative urostomies 156
Post-operative faecal stomas 157
Wound care 157
Post-operative stoma care teaching 157
Teaching plan 158
Stoma closure 159
Small bowel obstruction 159
Wound infection 160
Abdominal sepsis 160
References 160
Chapter 10: Intestinal Pouches 164
Introduction 164
The coloanal or colonic ‘J’ pouch 164
The Kock pouch/reservoir 165
The ileoanal pouch 166
Patient suitability and selection 167
The ‘S’, ‘J’ or ‘W’ pouch 167
Pre-operative counselling (surgical vs. medical approach) 168
Post-operative care 170
Anal skin care 170
Fertility, pregnancy and childbirth 171
Pouch absorption and diet 173
Problems following RPC 174
Research and current development 178
Laparoscopic surgery 179
Probiotics 180
Quality of life 180
Nursing developments 180
References 181
Chapter 11: Urinary Diversion 185
Introduction 185
Reasons for urinary diversion 185
Urostomy 185
Colonic conduit 186
The ileal conduit 186
Internal urinary pouches 190
Neobladder 195
Urinary drainage 197
The Mainz Sigma II pouch (modified ureterosigmoidostomy) 199
Support groups 203
References 203
Chapter 12: Appliances 205
Introduction 205
History of stoma care products 205
Modern pouches 207
Colostomy appliances 207
Ileostomy appliances 208
Urostomy appliances 208
Additional drainage bags 209
One- and two-piece appliances 210
Adhesive coupling system 210
Toilet flushable colostomy appliances 210
Stoma caps 211
Stoma plug 212
Appliances for high-output stomas 212
Fistula appliances 213
Convex flanges 213
Stoma accessories 214
Protective wafers/sheets 214
Skin cleansers 215
Paste 215
Seals and washers 216
Flange securing tape 216
Ostomy belts 216
Adhesive 216
Adhesive removers 217
Odour treatment options 217
Protective powder 217
Protective film 217
Protective cream 218
Pancaking prevention agents 218
Discharge solidifying agents 218
Pouch clips and soft ties 219
Pouch covers 219
Flatus filters 219
Hernia support garments 219
Protective shields 220
Clothing 220
Stoma appliance costing 220
Conclusion 221
References 221
Chapter 13: Discharge to the Community 223
Introduction 223
Discharge criteria 223
Stoma supplies 224
Disposal of appliances 225
Obtaining further supplies 225
Nurse prescribing 226
Appliances 226
Follow-up visits 226
Post-operative psychological adjustment 227
Returning to work 227
Resuming social activities and hobbies 228
Exercises 228
Driving 228
Clothing 229
Alcohol 229
Support garments 229
Travel 229
Long-term follow-up 229
References 230
Chapter 14: Nutrition 232
Introduction 232
Digestion and absorption of nutrients 232
‘The Balance of Good Health’ 233
Colostomy 236
Dietary management of functional problems post-colostomy formation 237
Ileostomy 239
Dietary management of functional problems post-ileostomy formation 240
Ileoanal pouch 243
Dietary management of functional problems post-ileoanal pouch formation 244
Urostomy 247
Dietary management of functional problems following urostomy formation 247
Peri-operative nutrition 248
Provision of nutrition support 249
Monitoring 250
Conclusion 250
References 250
Further reading 254
Chapter 15: Complications 255
Introduction 255
Short-term complications 255
Long-term complications 255
Allergy and skin sensitivities 255
Bleeding 256
Cancer recurrence locally 256
Crohn’s disease 256
Constipation 257
Diarrhoea 257
Discolouration of the stoma 257
Flatus 257
Granulomas/overgranulation 258
Hernia 258
High-output stoma 260
Ileus (paralytic ileus) 260
Infection 261
Melanosis coli 262
Mucocutaneous separation 262
Necrosis 262
Obstruction 263
Odour 263
Pancaking 264
Phantom bladder/rectum 264
Prolapse 264
Pyoderma gangrenosum 265
Retraction 265
Skin problems 266
Stenosis 268
Stoma trauma 268
Urine crystal formation 268
Varices 269
Conclusion 269
References 269
Chapter 16: Fistulae and Intestinal Failure 273
Introduction 273
Defining fistulae 273
Intestinal failure 283
Parenteral nutrition (PN) 288
Fistuloclysis 289
Conclusion 290
References 290
Chapter 17: Bowel Irrigation 293
Introduction 293
Rectal irrigation 293
Colonic irrigation 295
Colostomy irrigation 295
Travel 302
Antegrade colonic enemas (ACEs) 302
Percutaneous endoscopic colostomy (PEC) 304
Conclusion 307
References 307
Chapter 18: Other Stoma Issues 310
Introduction 310
Age related issues 310
Drugs 312
Exercise 314
Psychological issues 316
Body image 317
Sexual issues 317
Specialist clothing 320
Toilet access 321
Cultural issues 321
Religious issues 321
Travel 322
Quality of life 323
Conclusion 323
References 323
Index 326

Produkt-Details

• Erscheint lt. Verlag: 15.9.2008
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Pflege
• Schlagworte: Accessory • adjuvant • ammatory • bowel • burch • Chemotherapy • Colorectal • contributors • Disease • Effects • Future • GI Tract • History • INFL • Investigations • Krankenpflege • List • nursing • Pflege • Stoma Care • Stomas • stoma specialist nurse • system jennie • toliashah • Urinary
• ISBN-10: 0-470-72214-2 / 0470722142
• ISBN-13: 978-0-470-72214-5 / 9780470722145