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A nurse is doing discharge teaching on a client with a colostomy. What would the nurse convey to the client regarding when is the best time to perform irrigation?
- A. After a meal.
- B. After a bowel movement.
- C. During a meal.
- D. Two hours before a meal.
Correct Answer: D
Rationale: The correct answer is D: Two hours before a meal. This timing allows for the colon to be relatively empty, making irrigation more effective. Irrigating two hours before a meal helps to prevent interference with digestion and absorption processes. Irrigating after a meal (choice A) or during a meal (choice C) may lead to discomfort, bloating, or potential leakage. Irrigating after a bowel movement (choice B) may not provide enough time for the colon to be adequately empty for effective irrigation.
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The Kupffer cells are phagocytic cells found in the _____.
- A. gallbladder
- B. pancreas
- C. intestine
- D. liver
Correct Answer: D
Rationale: The correct answer is D: liver. Kupffer cells are specialized macrophages found in the liver, where they play a crucial role in phagocytosis and immune responses. They help remove debris, toxins, and pathogens from the blood. The other options (A: gallbladder, B: pancreas, C: intestine) are incorrect because Kupffer cells are not typically present in these organs. The liver is the main site for Kupffer cells due to its role in filtering and processing blood.
The muscles of the esophagus squeeze the food downward using the process of:
- A. gravity
- B. peristalsis
- C. rugae
- D. chyme
Correct Answer: B
Rationale: The correct answer is B: peristalsis. Peristalsis is the coordinated, rhythmic muscle contractions that propel food through the esophagus and digestive tract. This process helps move food downward towards the stomach. Gravity (choice A) is not the primary mechanism for moving food through the esophagus. Rugae (choice C) refers to folds in the stomach lining, not muscle action in the esophagus. Chyme (choice D) is the partially digested food mixed with stomach acids and enzymes, not a process of moving food down the esophagus. Therefore, peristalsis is the correct answer as it accurately describes the muscle action involved in pushing food downward through the esophagus.
The coronary ligament attaches the
- A. liver to the diaphragm.
- B. liver to the anterior abdominal wall.
- C. colon to the posterior body wall.
- D. lesser curvature of the stomach and proximal end of the duodenum to the liver and diaphragm.
Correct Answer: A
Rationale: The correct answer is A because the coronary ligament attaches the liver to the diaphragm. This ligament forms part of the peritoneal ligaments that secure the liver to the diaphragm, supporting its position in the abdominal cavity. The other choices are incorrect because: B) The liver is attached to the anterior abdominal wall by the falciform ligament, not the coronary ligament. C) The colon is attached to the posterior body wall by the mesocolon, not the coronary ligament. D) The lesser curvature of the stomach and proximal end of the duodenum are attached to the liver and diaphragm by the lesser omentum, not the coronary ligament.
The function of the gastrointestinal tract can be classified in several ways. Which of the following functions is most important for survival immediately after a meal?
- A. Absorption and retention of water and electrolytes
- B. Elimination of toxins
- C. Maintenance of barrier function
- D. Extraction of maximum value from nutrients
Correct Answer: A
Rationale: The correct answer is A: Absorption and retention of water and electrolytes. Immediately after a meal, the body needs to absorb water and electrolytes to maintain proper hydration and electrolyte balance, crucial for survival. This process helps in nutrient absorption and maintaining overall body function.
Reasons for why the other choices are incorrect:
B: Elimination of toxins - While important for overall health, elimination of toxins is not the most critical function immediately after a meal for survival.
C: Maintenance of barrier function - While important for protecting against harmful substances, it is not the most vital function immediately after a meal for survival.
D: Extraction of maximum value from nutrients - While important for optimal nutrition, it is not as crucial as absorption and retention of water and electrolytes for immediate survival post-meal.
The patient with a new ileostomy needs discharge teaching. What should the nurse plan to include in this teaching?
- A. The pouch can be worn for up to 2 weeks before changing it.
- B. Decrease the amount of fluid intake to decrease the amount of drainage.
- C. The pouch can be removed when bowel movements have been regulated.
- D. If leakage occurs, promptly remove the pouch, clean the skin, and apply a new pouch.
Correct Answer: D
Rationale: The correct answer is D because in the event of leakage from the pouch, it is important to promptly remove it, clean the skin, and apply a new pouch to prevent skin irritation and infection. This step is crucial for maintaining skin integrity and preventing complications.
Choice A is incorrect as ileostomy pouches typically need to be changed more frequently, usually every 3-7 days, to prevent skin breakdown and odor.
Choice B is incorrect because decreasing fluid intake can lead to dehydration and electrolyte imbalances, which are especially risky for ileostomy patients who have increased fluid losses.
Choice C is incorrect because the pouch should not be removed until the stoma and bowel movements have been evaluated and regulated to ensure proper functioning.