Certified Medical-Surgical Registered Nurse Practice Exam

After a total proctocolectomy, when should the nurse expect the ileostomy to start draining?

1. Within 6 hours after surgery.

2. Within 12 hours after surgery.

3. Within 24 hours after surgery.

4. Within 48 hours after surgery.

The correct answer is: Within 24 hours after surgery.

Following a total proctocolectomy, the ileostomy typically starts to drain as the bowel begins to resume its normal function. This process generally occurs within 24 hours post-surgery. Immediately after the procedure, the gastrointestinal tract is often not functional due to the effects of anesthesia and the surgical manipulation involved, which can temporarily suspend peristalsis. By the 24-hour mark, most patients will start to see drainage from the ileostomy as the bowel begins to wake up and the digestive process resumes. The timeline can vary slightly among individuals, but the expectation is rooted in the physiological recovery of the gastrointestinal tract. Factors such as the extent of surgery, individual healing rates, and the presence of any postoperative complications can influence this timeline. However, it is widely accepted in clinical practice that drainage from an ileostomy after surgery generally occurs within this 24-hour timeframe.