Nokea
A patient has had an ileostomy created for the treatment of irritable bowel disease and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting?
- A. Apply antibiotic ointment as ordered after cleaning the stoma.
- B. Apply a skin barrier to the peristomal skin prior to applying the pouch.
- C. Dispose of the clamp with each bag change.
- D. Cleanse the area surrounding the stoma with alcohol or chlorhexidine.
Correct Answer: B
Rationale: Guidelines for changing an ileostomy appliance are as follows. Skin should be washed with soap and water, and dried. A skin barrier should be applied to the peristomal skin prior to applying the pouch. Clamps are supplied one per box and should be reused with each bag change. Topical antibiotics are not utilized, but an antifungal spray or powder may be used.
You may also like to solve these questions
A patient has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurses care should prioritize which of the following outcomes?
- A. Preventing infection
- B. Maintaining skin and tissue integrity
- C. Preventing nausea and vomiting
- D. Maintaining fluid and electrolyte balance
Correct Answer: D
Rationale: All of the listed focuses of care are important for the patient with a small bowel obstruction. However, the patients risk of fluid and electrolyte imbalances is an immediate threat to safety, and is a priority in nursing assessment and interventions.
A nurse is talking with a patient who is scheduled to have a hemicolectomy with the creation of a colostomy. The patient admits to being anxious and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. Which of the following nursing actions is most appropriate?
- A. Reassure the patient that the procedure is relatively low risk and that patients are usually successful in adjusting to an ostomy.
- B. Provide the patient with educational materials that match the patients learning style.
- C. Encourage the patient to write down these concerns and questions to bring forward to the surgeon.
- D. Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse.
Correct Answer: D
Rationale: A wound-ostomy-continence (WOC) nurse is a registered nurse who has received advanced education in an accredited program to care for patients with stomas. The enterostomal nurse therapist can assist with the selection of an appropriate stoma site, teach about stoma care, and provide emotional support. The surgeon is less likely to address the patients psychosocial and learning needs. Reassurance does not address the patients questions, and education may or may not alleviate anxiety.
A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, what characteristics would the nurse anticipate for the patient's stools?
- A. Watery with blood and mucus
- B. Hard and black or tarry
- C. Dry and streaked with blood
- D. Loose with visible fatty streaks
Correct Answer: A
Rationale: The predominant symptoms of ulcerative colitis are diarrhea and abdominal pain. Stools may be bloody and contain mucus. Stools are not hard, dry, tarry, black, or fatty in patients who have ulcerative colitis.
A nurse is caring for a patient admitted with symptoms of an anorectal infection; cultures indicate that the patient has a viral infection. The nurse should anticipate the administration of what drug?
- A. Acyclovir (Zovirax)
- B. Doxycycline (Vibramycin)
- C. Penicillin (penicillin G)
- D. Metronidazole (Flagyl)
Correct Answer: A
Rationale: Acyclovir (Zovirax) is often given to patients with viral anorectal infections. Doxycycline (Vibramycin) and penicillin (penicillin G) are drugs of choice for bacterial infections. Metronidazole (Flagyl) is used for other infections with a bacterial etiology; it is ineffective against viruses.
The nurse is caring for a patient who is undergoing diagnostic testing for suspected malabsorption. When taking this patients health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis?
- A. Recurrent constipation coupled with weight loss
- B. Foul-smelling diarrhea that contains fat
- C. Fever accompanied by a rigid, tender abdomen
- D. Bloody bowel movements accompanied by fecal incontinence
Correct Answer: B
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea or frequent, loose, bulky, foul-smelling stools that have increased fat content and are often grayish (steatorrhea). Constipation and bloody bowel movements are not suggestive of malabsorption syndromes. Fever and a tender, rigid abdomen are associated with peritonitis.