Pregnancy with an Ostomy Questions

1. Constipation needs to be taken seriously since it can lead to a bowel obstruction. If not treated, a bowel obstruction can lead to:

a. Maternal death (correct)
b. Appendicitis
c. Urinary tract infection
d. Strained periformis

Answers b, c, and d are not caused by a bowel obstruction. Maternal death is a potential complication of a bowel obstruction because it is often confused with preterm labor and goes untreated by providers unfamiliar with ostomies.

2. Which of the following stomal complications requires immediate surgical evaluation?

a. Lacerations
b. Severe stenosis (correct)
c. Hernia
d. Retraction

Answers a, c, and d are usually corrected without medical intervention with changes to stoma care or they usually resolve after birth.

3. Nausea and vomiting can lead to all of the following complications except:

a. Fluid and electrolyte imbalances
b. Constipation
c. Endometriosis (correct)
d. Dehydration

Answers a, b, and d can all be caused by nausea and vomiting.

4. Which of the following methods of birth control would not be effective for a woman with an ileostomy?

a. Diaphragm
b. Intrauterine device
c. Oral contraceptives (correct)
d. Condoms

Answers a, b, and d are effective if appropriate for the individual. Depending on the amount of intestines that remain, the absorption of oral contraceptives may be unreliable and therefore not effective for a woman with an ileostomy.

5. Changes in the size and shape of a stoma can cause leaks, skin breakdown, and damage to the stoma. Complications with the stoma can be minimized by all of the following except:

a. Using a mirror to locate and observe the stoma during appliance change
b. Changing the type of appliance used and/or using additional adhesive
c. Consult with ostomy associations and support groups for advice and emotional support
d. Using lotion on the peristomal skin before applying a new wafer (correct)

Answers a, b, and c are all appropriate measures to maintain appropriate appliance fit, minimize leaks, and reduce complications. Lotion is not used on peristomal skin because it will prevent proper wafer adhesion. The area should be washed thoroughly with mild soap and warm water. Rinse and dry the skin completely with a dry soft cloth. All stool or wafer residue must be removed and hair around stoma should be shaved or clipped. Soaps that contain baby oil, cold cream, or perfumes should not be used.