Nokea
The nurse is caring for a client who has undergone colostomy. Which of the following instructions should the nurse include in the teaching plan?
- A. Restrict traveling by air.
- B. Limit outdoor activities.
- C. Avoid light clothing.
- D. Chew food well.
Correct Answer: D
Rationale: The nurse should instruct a client who has undergone colostomy to chew food properly. This helps decrease gas that results chiefly from swallowing air rather than from digestion. The client need not limit or avoid travel or outdoor activities. If traveling by air, the nurse should instruct the client to take ostomy supplies in carry-on luggage to prevent their loss if luggage is misdirected or lost. If the client requires firm, light support, he or she should find a stoma shield to help prevent irritation or undue pressure on the stoma.
You may also like to solve these questions
A client scheduled for a total colectomy has been taking the immunosuppressive agent, azathioprine. As part of the nurse's preoperative teaching, when should the client be told to discontinue the medication to prevent negative effects on tissue healing?
- A. 3 days before surgery
- B. 1 week before surgery
- C. 1 month before surgery
- D. 3 months before surgery
Correct Answer: C
Rationale: Immunosuppressive agents such as azathioprine, 6-mercaptopurine, and cyclosporine should be discontinued 3 to 4 weeks before surgery to prevent negative effects on tissue healing. Aspirin-containing compounds are discontinued at least 1 week before surgery to decrease the risk of bleeding.
The nurse is discussing care of the client's ileostomy and is instructing the client to avoid certain medications that move through without being absorbed. What medications should the client avoid? Select all that apply.
- A. Enteric-coated products
- B. Liquid medication
- C. Slow-release beads
- D. Layered tablets
- E. Chewable tablets
Correct Answer: A,C,D
Rationale: Clients with an ileostomy should avoid enteric-coated products and some modified-release drugs, such as slow-release beads and layered tablets. These products may pass through without being absorbed. The client may take liquid and chewable tablets because they will go through the breakdown process in the stomach.
A male client, age 32 years, was recently married, and he and his wife would like to have children. The client is scheduled to have a total colectomy and is concerned with being able to have children. What is the best answer given by the nurse related to the client's concern?
- A. There is no risk of you not being able to father children after this surgery.'
- B. Certainly understand your concern, but there are other options such as artificial insemination with a donor.'
- C. You may want to consider collection and storing of sperm for later use if you are planning to have children.'
- D. Infertility is a side effect of this surgery and should be considered carefully.'
Correct Answer: C
Rationale: Young male clients may wish to collect and store sperm for later use if they plan to have children. Sexual dysfunction in men after a total colectomy is unusual but sometimes occurs. If such dysfunction persists after a colectomy, operative and nonoperative options are available to facilitate erection.
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 nurse is caring for a client about to have the first stage of an ileoanal anastomosis. What should the nurse inform the client they will experience?
- A. Solid stool from the anus
- B. Very little discharge from the anus
- C. Control of the fecal material from the anus
- D. Continuous discharge of mucus from the anus
Correct Answer: D
Rationale: After the first stage of surgery, clients experience an almost continuous discharge of mucus from the anus and a frequent discharge of fecal material from the ileostomy. Initially, clients cannot control the frequent watery discharge.