Nokea
A nurse is preparing to administer the prescribed vitamin B12 to a client who has had most of his ileum removed. The nurse understands that this is necessary for which reason?
- A. Prevents thrombosis
- B. Prevents deficiencies
- C. Aids proper digestion
- D. Prevents constipation
Correct Answer: B
Rationale: Parenteral injections or intranasal administrations of vitamin B12 are used to prevent deficiencies in clients who have had most or all of the ileum removed because this area is responsible for B12 absorption. Vitamin B12 does not prevent thrombosis or constipation or aid digestion.
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A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. The nurse would monitor this client for which of the following?
- A. Cerebral anoxia
- B. Cardiac dysrhythmias
- C. Hypothyroidism
- D. Adrenal insufficiency
Correct Answer: D
Rationale: Adrenal crisis is potentially life-threatening and may result from the abrupt withdrawal of corticosteroids. Therefore, the nurse should closely monitor a client who is scheduled for an ileostomy surgery for adrenal insufficiency, resulting from corticosteroid withdrawal. Withdrawal of corticosteroids does not cause cerebral anoxia, cardiac dysrhythmias, or hypothyroidism.
The client is having a total colectomy with an ileostomy created. What does the nurse explain to the client that the stool consistency will be?
- A. Liquid or mushy
- B. Bloody, soft
- C. Small balls of feces
- D. Thin and firm
Correct Answer: A
Rationale: The fecal material discharged from an ileostomy is liquid or mushy and contains digestive enzymes. The stool does not have time to harden since there is not the large intestine available to process it.
The nurse is caring for a client who is to undergo surgery for the creation of a continent ileostomy. Which statement by the client indicates the nurse's teaching has been successful?
- A. I'll need to empty the appliance more frequently.'
- B. I'll need to learn how to empty the reservoir several times a day.'
- C. My stool will be loose initially but then become formed in a week or so.'
- D. If I just push on the valve and the drainage will flow out easily.'
Correct Answer: B
Rationale: A continent ileostomy involves the creation of an internal reservoir for the storage of GI effluent. It stores the effluent for several hours until the client removes it with a catheter. Initially, the reservoir is emptied every 2 to 4 hours, and then three to four times per day as the capacity of the reservoir increases (usually in about 6 months). This reservoir eliminates the need to wear an external appliance. Stool will continue to be liquid at all times. A continent ileostomy does have a nipple valve through which a catheter is inserted to drain the reservoir.
The nurse is providing ostomy care to the client with an ileostomy. What can the nurse use to promote adhesion of the ostomy appliance?
- A. Adhesive glue
- B. Tincture of Benzoin
- C. Vaseline
- D. Karaya paste
Correct Answer: D
Rationale: Karaya paste, which becomes gelatinous when in contact with moisture, is commonly used in place of an adhesive. Karaya paste promotes adhesion of the ostomy appliance.
The nurse is assessing the stool consistency of a client with an ascending colostomy. Which of the following would the nurse expect to find?
- A. Liquid
- B. Liquid to pasty
- C. Soft
- D. Formed
Correct Answer: B
Rationale: The consistency of fecal material ranges from semiliquid to formed depending on the area from which the colostomy is formed. With an ascending colostomy, stool would be liquid to pasty. An ileostomy would produce liquid stool, a transverse colostomy would produce soft stool; a sigmoid colostomy would produce formed stool.