Ostomy Types and Characteristics
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Questions and Answers

What is the primary purpose of ceramide-infused barriers?

  • To assist with stoma sizing.
  • To maintain skin integrity and prevent water loss. (correct)
  • To provide pressure for better fit.
  • To increase barrier wear time.

Which barrier type is most suitable for patients with a firm abdomen?

  • Flat Barrier (correct)
  • Cut-to-fit Barrier
  • Soft Convex Barrier
  • Elastic Barrier

What can help prevent leakage from an ostomy pouch?

  • Applying more adhesive to the barrier.
  • Ensuring the pouch is emptied regularly. (correct)
  • Regularly changing the ostomy supplies.
  • Using thick skin creams around the stoma.

What is the purpose of barrier rings?

<p>To provide an extra layer of protection under the barrier. (B)</p> Signup and view all the answers

What is the approximate annual cost of having an ostomy without insurance?

<p>$1,500 to $4,000 (D)</p> Signup and view all the answers

Which of the following statements about Hollister products is true?

<p>A year's supply can average around $5,000. (C)</p> Signup and view all the answers

What is the function of using powder on damaged skin before applying a barrier?

<p>To help dry out the area. (D)</p> Signup and view all the answers

Why is it important to check the fit of barriers regularly?

<p>Stomas can change shape over time. (B)</p> Signup and view all the answers

What happens to a person's breathing when they overdose on opioids?

<p>Breathing slows down considerably (D)</p> Signup and view all the answers

What is the main action of naloxone when used during an opioid overdose?

<p>It blocks the opioid receptors in the brain (A)</p> Signup and view all the answers

What is a critical limitation of naloxone in treating opioid overdoses?

<p>It only works if opioids are present (B)</p> Signup and view all the answers

Which of the following increases the risk of overdose when consuming opioids?

<p>Combining opioids with benzodiazepines (A)</p> Signup and view all the answers

How quickly can naloxone restore breathing after administration?

<p>Within 2 to 5 minutes (B)</p> Signup and view all the answers

What is the primary purpose of compression socks?

<p>To promote blood circulation and prevent pooling in the veins (A)</p> Signup and view all the answers

When is it recommended to take off compression socks?

<p>At the end of the day (B)</p> Signup and view all the answers

How is the sizing for over-the-counter compression socks typically determined?

<p>By shoe size (B)</p> Signup and view all the answers

Which compression strength is considered light compression?

<p>15-20 mmHg (D)</p> Signup and view all the answers

What might be a sign that someone needs compression socks?

<p>Tired, achy legs (C)</p> Signup and view all the answers

What is the proper use of compression socks while sleeping?

<p>They should not be worn while sleeping. (C)</p> Signup and view all the answers

For whom are compression socks especially beneficial?

<p>Pregnant women experiencing increased pressure on veins (C)</p> Signup and view all the answers

What is NOT needed on a prescription when obtaining compression socks?

<p>Ankle measurement size (B)</p> Signup and view all the answers

What is the primary reason for the rise in opioid-related deaths in Canada?

<p>Contaminated illegal drug supply (B)</p> Signup and view all the answers

Which compression level is most commonly prescribed for moderate vein problems?

<p>20-30 mmHg (D)</p> Signup and view all the answers

What is one potential consequence of long-term use of prescription opioids?

<p>Tolerance requiring higher doses (A)</p> Signup and view all the answers

Which of the following reasons contributes to the low access to harm reduction services?

<p>Stigma surrounding substance use (B)</p> Signup and view all the answers

Which compression level is typically used for severe conditions like DVT and ulcers?

<p>30-40 mmHg (A)</p> Signup and view all the answers

How does opioid tolerance affect individuals who stop using opioids?

<p>It decreases rapidly, increasing overdose risk (D)</p> Signup and view all the answers

What is the potential effect of contaminated drugs, such as those laced with fentanyl?

<p>Fatality from just a few grains (C)</p> Signup and view all the answers

What type of compression garments are generally available over-the-counter and not typically covered by insurance?

<p>10-15 mmHg (C)</p> Signup and view all the answers

What is the first step to take when you suspect someone is experiencing an opioid overdose?

<p>Shake the person and shout at them (D)</p> Signup and view all the answers

Who is NOT a recommended candidate for naloxone administration?

<p>A person with a stable heart condition (A)</p> Signup and view all the answers

What should be done if a person does not respond after the first naloxone dose?

<p>Administer another dose after 2-3 minutes (D)</p> Signup and view all the answers

What are common side effects experienced during withdrawal after naloxone administration?

<p>Nausea, vomiting, and muscle aches (B)</p> Signup and view all the answers

What is the proper way to administer naloxone via injection?

<p>Break ampoule, pull into needle, inject into large muscle (A)</p> Signup and view all the answers

Which of the following groups should ideally be offered a naloxone kit?

<p>All patients using opioids, especially those on high doses or combined with other sedatives (D)</p> Signup and view all the answers

During CPR after naloxone administration, where should you place your hands for chest compressions?

<p>In the center of the chest between the nipples (A)</p> Signup and view all the answers

What is an appropriate action if the environment is too bright for a person waking up from an overdose?

<p>Make the environment more comfortable by reducing bright lights (A)</p> Signup and view all the answers

What is the primary function of a TENS machine in physiotherapy?

<p>To provide pain relief through electrical stimulation (B)</p> Signup and view all the answers

Which therapy device uses sound waves to assist in tissue repair?

<p>Ultrasound therapy device (C)</p> Signup and view all the answers

What type of therapy unit is utilized to reduce swelling and inflammation?

<p>Hot and cold therapy unit (C)</p> Signup and view all the answers

What type of device is commonly used to help improve muscle function and reduce spasms?

<p>Electrotherapy device (D)</p> Signup and view all the answers

Which program may provide financial assistance for physiotherapy-related equipment in Ontario?

<p>Ontario Assistive Devices Program (ADP) (B)</p> Signup and view all the answers

In which scenario is the Ontario Health Insurance Plan (OHIP) likely to cover physiotherapy sessions?

<p>For low-income seniors or inpatient treatments (B)</p> Signup and view all the answers

Which equipment is primarily used for rehabilitation exercises?

<p>Resistance bands (A)</p> Signup and view all the answers

What is the main benefit of using hot therapy in physiotherapy?

<p>To improve blood flow and relax muscles (C)</p> Signup and view all the answers

Flashcards

Barrier Wear Time

Barriers last 5-7 days, depending on patient activity and body condition

Ceramide-infused Barriers

Help maintain skin integrity and prevent water loss, forming a protective, waterproof layer.

Flat Barrier use

Best for firm abdomen, post-op edema, or minimal movement.

Soft Convex Barrier use

Best for patients transitioning home or with more active lifestyles.

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Barrier Rings use

Placed under the barrier for extra protection, often made of ceramide.

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Prevent Leakage - Correct Fit

Pouching system fit snugly around the stoma to prevent leaks.

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Government Ostomy Funding

$975 annually (paid in 2 installments).

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Ostomy Supply Cost (Private)

Annual costs range $1,500-$4,000 depending on patient needs.

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Compression Socks

Socks designed to apply pressure to the lower legs, improving blood circulation and preventing blood pooling in the veins.

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Compression Strength (mmHg)

A measure of the pressure exerted at the ankle of the compression sock, indicating the intensity of the compression.

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15-20 mmHg Compression

A light compression, suitable for mild swelling, tiredness, and aches in the legs.

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Over-the-counter Compression Socks Sizing

Measured by shoe size.

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Prescription Compression Socks Sizing

Measured from the knee to the ankle.

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Prescription Compression Socks Information

Requires length (e.g., knee-high, thigh-high), compression strength (mmHg), and diagnosis from a doctor.

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Indications for Compression Socks

Conditions like pregnancy, prolonged standing, and prevention of venous issues (e.g., varicose veins) or DVT.

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Deep Vein Thrombosis (DVT)

A blood clot in a deep vein, often in the leg, which can be dangerous.

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Compression Stockings

Medical stockings used to improve blood circulation in the legs.

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Compression Levels

Different levels of compression stockings: 20-30 mmHg, 30-40 mmHg, and 40+ mmHg.

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Opioid Overdose Deaths

Accidental deaths in Canada caused by opioids.

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Opioid Crisis Causes

Contaminated illegal drugs (often with Fentanyl), prescription opioids, opioid tolerance/dependence, and barriers to treatment.

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Opioid Tolerance

The body's adaptation to opioids, requiring higher doses for the same effect.

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Opioid Dependence

The body's physical reliance on opioids, making withdrawal difficult.

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Naloxone

An opioid overdose reversal medication.

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Accidental Opioid Deaths

Opioid deaths in Canada that are accidental.

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Opioid Overdose

Taking too much opioid medication, causing slowed breathing, unconsciousness, or even death.

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Withdrawal Symptoms

Unpleasant physical effects that happen when opioid use is stopped or reduced quickly.

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Naloxone Effectiveness

Reverses overdose in at least 90% of cases when administered immediately.

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Opioids and Other Drugs

Taking opioids with other medications (like benzodiazepines, anxiety meds, or muscle relaxants) or alcohol increases overdose risk.

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Physiotherapy Specialties

Physiotherapy focuses on personalized care for various needs, including pain management, rehabilitation, mobility improvement, and preventative measures.

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TENS Machine

A device that uses electrical stimulation to relieve pain by blocking pain signals to the brain.

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Ultrasound Therapy

Uses sound waves to penetrate deep tissues, reducing pain, swelling, and promoting tissue repair.

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Electrotherapy

Stimulates muscles and nerves to improve function, reduce pain, and aid recovery.

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Hot and Cold Therapy

Uses heat to improve blood flow and relax muscles, and cold to reduce swelling and inflammation.

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Compression Therapy

Uses compression devices, like stockings or bandages, to improve blood circulation and reduce swelling.

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Rehabilitation Equipment

Tools used during physiotherapy sessions to rebuild strength and mobility, such as resistance bands, balance boards, and foam rollers.

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Physiotherapy Coverage in Ontario

Ontario Health Insurance Plan (OHIP) may cover physiotherapy sessions in certain cases, while private insurance often covers sessions and partly reimburses for devices. The Assistive Devices Program (ADP) helps with equipment costs.

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Naloxone: Safe for all?

Naloxone is safe to administer to individuals of all ages, even those with pre-existing health conditions like pregnancy, heart disease, or kidney disease.

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Naloxone Side Effects

Naloxone has minimal side effects. Multiple doses are safe.

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Multiple Naloxone Doses

In cases of Fentanyl opioid overdoses, multiple doses of naloxone may be needed.

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Signs of Opioid Overdose

Recognizing opioid overdose includes signs such as weak or no breathing, pinpoint pupils, cyanosis (blue skin), cold skin, limp body, and unresponsiveness to shouting.

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When to Call 911

Immediately call 911 after administering naloxone. Naloxone is a temporary antidote, and paramedics must arrive to provide further care.

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Naloxone: Nasal vs Injectable

Naloxone can be administered both nasally and intravenously. The nasal route requires no priming. Injectable naloxone is administered into a large muscle, like the deltoid or thigh.

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Aftercare: Post-Naloxone Withdrawal

Following naloxone administration, the patient might experience discomfort, irritability, nausea, vomiting, diarrhea, muscle aches, and sweating. These symptoms are typical and temporary.

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Who to Offer a Naloxone Kit?

It's recommended to offer naloxone kits to patients who are on methadone or suboxone, are taking high doses of opioids, are taking opioids for the first time, or are taking opioids with benzodiazepines, sedatives, or gabapentin.

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Study Notes

Ostomy

  • An ostomy is a surgically created opening in the body to remove bodily waste.
  • This is needed when parts of the digestive or urinary tract are removed or bypassed.
  • The stoma allows waste to exit the body when natural bodily functions are not possible.
  • The stoma is the hole or opening in the body.
  • There is no control over the output from the stoma, so patients wear a pouch to collect waste.

Types of Ostomies

  • Colostomy: Thicker, formed stool, typically involves the large intestine.
  • Ileostomy: Thicker, formed stool, typically involves the large intestine.
  • Urostomy: Primarily liquid or gas, related to urine, diverts urine from the kidneys through a stoma.

Characteristics of a Normal Stoma

  • Color: Pink or dark red.
  • Moist: Should be moist; this is a healthy sign.
  • Painless: The stoma itself doesn't have pain receptors.
  • Size: Varies depending on the patient and procedure.
  • Shape: May be flat or protrude slightly, some stomas may have one or two openings.

Pouching System

  • Used to collect stoma effluent (waste).
  • Essential to have a secure seal and protect the skin around the stoma to prevent irritation.
  • Two main types of pouch systems:
    • Two-piece system (separate barrier and pouch).
    • Color-coding for items is common (e.g., red, blue, green) with red being a common size.

Barriers

  • Come in soft convex, flat, or convex options to fit different body shapes.
  • Draining opening: Velcro or lock-and-roll for easier emptying.
  • One-piece system: Single unit worn directly on the skin, draining opening.
  • Disposable option: No draining opening. Ideal for swimming or other activities.
  • Pre-cut vs. cut-to-fit: Cut-to-fit are usually preferred.
  • Cut-to-fit needs trial and error to fit appropriately.
  • Barrier wear time: 5-7 days, depending on the patient's activity and body condition.
  • Ceramide-infused barriers help maintain skin integrity and prevent water loss.

Fitting Considerations

  • Flat barrier: For firm abdomen, post-op edema or minimal movement.
  • Soft convex barrier: For patients transitioning home or with more active lifestyles.

Ostomy Accessories

  • Barrier rings: Placed under the barrier for additional protection.
  • Belts: Provide extra pressure for a better fit.
  • Powder: For damaged skin, helping dry the area before applying a new barrier.
  • Burping the pouch: Some pouches have filters to release gas, preventing odors and bloating.

Preventing Leakage

  • Regular emptying is crucial to prevent leakage.
  • Correct fit of the pouching system is vital to prevent leaks.

Cost of Having an Ostomy

  • Government funding: $975 annually (paid in two installments).
  • Private coverage: Annual costs can range from 1,500to1,500 to 1,500to4,000, depending on patient needs.
  • Hollister products: Sold through pharmacies, a year's supply can cost around $5,000 with one-piece systems being less expensive than two-piece systems.

Insurance and Coverage

  • Some Hollister products are covered under the ODB program.
  • Secure Start Program: Hollister's patient support program offers free samples and guidance. This assistance can be accessed via the website or paper forms.
  • Use skin-protective wipes to gently remove barriers and protect the peristomal skin.
  • Rotating application sites is important to prevent stoma irritation.

Compression Therapy/Socks

  • Take off at the end of the day.
  • Do not wear while sleeping.
  • Used for standing and applying pressure.
  • Helpful for venous return to the heart.
  • Reduces swelling and discomfort in legs.
  • Reduces risk of deep vein thrombosis.

Compression Strengths

  • Compression strength: 15-20 mmHg (light), 20-30 mmHg (moderate), 30-40 mmHg (severe), and 40+ mmHg (very severe).
  • 15-20 mmHg: Light compression, commonly used for mild swelling, usually available over-the-counter.
  • 20-30 mmHg: Commonly used for moderate vein or swelling issues, prescription might be required.
  • 30-40 mmHg: Used for conditions like DVT, ulcers, or venous insufficiency, requires a prescription.
  • 40+ mmHg: Not commonly used but may be prescribed for severe venous conditions or specific medical issues.

Naloxone

  • Opioid overdose reversal agent.
  • A "temporary antidote" that kicks opioids off receptors in the brain, and binds in their place.
  • Very short-lived, the effect is relatively temporary.
  • Available without a prescription in Ontario pharmacies.

Administering Naloxone

  • Steps to administer naloxone:
    • Shake and shout to check for response.
    • Call Emergency Services (911).
    • Inject naloxone if needed into a large muscle (IM).
    • Perform CPR if necessary.

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Description

This quiz covers the essentials of ostomies, including their definition, various types such as colostomy, ileostomy, and urostomy. Participants will learn about the characteristics of a normal stoma and what to expect post-surgery. It's a crucial topic for understanding surgical waste management.

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