The nurse is doing pre-op teaching with the client who is about to undergo the creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
A. “I will need to drain the pouch regularly with a catheter.”
B. “I will need to wear a drainage bag for the rest of my life.”
C. “The drainage from this type of ostomy will be formed.”
D. “I will be able to pass stool from my rectum eventually.”
Correct Answer: A. “I will need to drain the pouch regularly with a catheter.”
A Kock pouch is a continent ileostomy. As the ileostomy begins to function, the client drains it every 3 to 4 hours and then decreases the draining to about 3 times a day or as needed when full. In this new operation, a pouch or reservoir is fashioned out of terminal ileum with a valve mechanism at its exit to the skin surface. This allows storage of the liquid bowel contents in an expandable container with no leakage of stool or gas and therefore no skin problems.
Option B: The client does not need to wear a drainage bag but should wear an absorbent dressing to absorb mucus drainage from the stoma. There is no need for appliances or bags, no embarrassment from the involuntary noise and smell of flatus through the ileostomy. The stoma is created flush and within the bikini line. The patient catheterizes the pouch an average of three times a day.
Option C: Ileostomy drainage is liquid. Ileostomy output will be liquid to pasty, depending on what the client eats, his medicines, and other factors. Because the output is constant, the client will need to empty the pouch 5 to 8 times a day.
Option D: The client would be able to pass stool only from the rectum if an ileal-anal pouch or anastomosis were created. This type of operation is a two-stage procedure. Not only does this procedure solve many of the complications of a conventional ileostomy, but it helps decrease the amount of emotional trauma suffered by the young ileostomist, greatly improving the quality of life.
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