COCN flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Normal stoma color

A healthy stoma is rose-red to pink and moist, like the inside of the mouth; a dusky, bluish, or black color indicates ischemia and needs immediate surgical notification.

Measuring an oval stoma

Measure the stoma at its base in both width and height using a measuring guide, because the pouching aperture must match an oval shape rather than a single diameter.

High-output ileostomy threshold

Ileostomy output greater than about 1,500 mL in 24 hours is high output, carrying risk of dehydration, sodium and potassium loss, and acute kidney injury.

DET score

The Ostomy Skin Tool scores peristomal skin from 0 to 15 across Discoloration, Erosion or ulceration, and Tissue overgrowth; a total of 0 indicates healthy intact skin.

Peristomal candidiasis signs

Fungal infection appears as erythema with satellite pustules or papules around the stoma; it is treated with topical antifungal powder under the barrier plus moisture control.

Pseudoverrucous lesion cause

Chronic exposure of peristomal skin to effluent or trapped adhesive moisture produces hyperkeratotic, warty-appearing lesions; correcting the pouching fit is the primary treatment.

Ileal conduit urine

Urostomy output normally contains mucus strands from the bowel segment; alkaline urine increases the risk of skin irritation and encrustation, so hydration and acidification are assessed.

Colostomy output character

Transverse colostomies usually produce semi-formed stool, while descending and sigmoid colostomies produce formed stool, which allows less frequent pouch emptying.

Stoma site marking

Mark the site with the patient supine, sitting, and standing, within the rectus muscle and away from creases, scars, bony prominences, the umbilicus, and the pannus fold.

Brooke ileostomy

A Brooke ileostomy is an end stoma whose mucosa is everted and sutured to the skin, creating a spout that helps protect skin from enzyme-rich liquid effluent.

Stoma edema timeline

Stoma edema peaks around postoperative days 2 to 3 and gradually resolves over 6 to 8 weeks, so the barrier opening must be recut as the stoma shrinks.

Postop stoma color checks

Assess stoma color every 4 hours for the first 24 hours after surgery, then per protocol; any dusky or black area is reported to the surgeon immediately.

First stool after ileostomy

Ileostomy function usually returns within 1 to 3 days after surgery, whereas a colostomy may take 3 to 5 days; delay with distension suggests ileus.

ERAS ostomy principles

Enhanced recovery elements include carbohydrate loading, avoidance of a routine nasogastric tube, opioid-sparing analgesia, early ambulation, and early oral intake after ostomy surgery.

Mucocutaneous separation care

Separation of the stoma from surrounding skin is managed by keeping the defect dry with stoma powder or a cohesive seal and avoiding firm convexity over the area until healing.

Ureteral stent removal

Stents placed during ileal conduit surgery are typically removed about 7 to 10 days postoperatively; urine may be blood-tinged and contains mucus strands.

Barrier opening size

Cut the skin barrier opening about 2 to 3 mm, or one-eighth inch, larger than the stoma base; a larger opening exposes skin to effluent and causes denudation.

Extended-wear barrier

Extended-wear skin barriers resist erosion and are used for liquid effluent from ileostomies and urostomies, while standard-wear barriers suit formed colostomy stool.

Convexity contraindications

Avoid convex pouching over ischemic or necrotic stoma tissue, mucocutaneous separation, active bleeding, or severely fragile skin, because pressure can worsen tissue damage.

Barrier paste function

Paste is a filler used to caulk gaps in creases and uneven skin, not an adhesive, and it does not replace a correctly sized barrier opening.

Crusting technique

For weeping denuded skin, dust stoma powder on the moist area, seal it with barrier film, and repeat before applying the pouch so the barrier adheres.

Pouch emptying volume

Empty a drainable pouch when it is one-third to one-half full; a full pouch adds weight, pulls the seal loose, and increases leakage risk.

Leakage and skin injury

Leakage of effluent under the barrier is the most common cause of peristomal skin injury, so skin problems are treated first by correcting the pouching fit.

Colostomy irrigation candidate

Irrigation is appropriate only for descending or sigmoid colostomies producing formed stool; it is never used for ileostomies or urostomies.

Urostomy night drainage

Urostomy pouches have a spout and antireflux valve and connect to a night drainage bag placed below bladder level so urine drains by gravity.

Teach-back method

The nurse asks the patient to explain or demonstrate ostomy care in their own words, confirming understanding before discharge rather than assuming teaching was effective.

PLISSIT model

A tiered framework for sexual concerns: Permission, Limited Information, Specific Suggestions, and Intensive Therapy, referring onward only when needs exceed the nurse's scope.

Ileostomy hydration guidance

People with ileostomies should drink about 2 to 3 liters of fluid daily and add salt to food, because sodium losses raise dehydration and electrolyte imbalance risk.

Odor-reducing foods

Yogurt, buttermilk, and parsley are reported to reduce ostomy odor, while fish, eggs, onions, garlic, and asparagus tend to increase it.

Postoperative lifting limit

Avoid lifting more than about 10 to 15 pounds for 6 to 8 weeks after ostomy surgery to reduce the risk of parastomal hernia formation.

Travel supply planning

Carry at least twice the usual ostomy supplies in carry-on luggage, keep a provider letter, and presize barriers, since checked baggage may be delayed.

Swimming with an ostomy

Swimming is permitted with the pouch in place; change the pouch beforehand, secure the edges with waterproof tape, and wear supportive swimwear for confidence.