Prep-U Chapter 48 ostomies Mastery 4

If the client is otherwise healthy, which stoma placement would result in a firm stool?

Sigmoid colostomy

A nurse is caring for a client with an ostomy pouch. When should the nurse ask the client to empty the pouch?

When the pouch is one-third to one-half full

13s What would be characteristic of an unhealthy stoma?

protrusion beyond 2 inches from the skin

A client is recovering from the creation of an ileostomy due to complications of a bowel disorder. The client has a history of arthritis and takes daily medication to reduce inflammation. Which medication will the health care provider avoid prescribing?

sustained-release tablets

Gregg Alderman, a 43-year-old investment banker, has been admitted to the medical-surgical unit where you practice nursing. Due to his lengthy history with Crohn's disease, he is preparing for a colostomy to remedy the complications. What are the necessary components of his individual care plan?

All options are correct

Which of the following statements about ostomy irrigation is true?

For some patients, regularly scheduled colostomy irrigation can be used to establish a predictable pattern of elimination.

30s A nurse is caring for a patient with a colostomy. What type of stools would she expect to find in the colostomy bag?

Formed

A nurse is providing discharge instructions for a patient with a new colostomy. Which of the following is a recommended guideline for long-term ostomy care?

Increase fluid intake, preferably of water, daily.

A patient with a diagnosis of colon cancer has required the creation of an ostomy following bowel surgery. What factor is most likely to influence the patient's adjustment to this change?

The coping mechanisms that the patient possesses

A patient's recent diagnosis of colorectal cancer has required a hemicolectomy (removal of part of the bowel) and the creation of a colostomy. The nurse would recognize that the patient's stoma is healthy when it appears:

dark pink and moist.

In a client with an ileoanal reservoir, perineal exercises involve tightening the anus and holding the contraction for a count of how many seconds before relaxing?

10

Which of the following stoma placements would result in a firm stool (under healthy circumstances)?

Colostomy

The normal appearance of a stoma should be:

Dark pink and moist

A client who has undergone colostomy surgery is experiencing constipation. Which intervention should the nurse consider for such a client

Dilate the stoma with a lubricated, gloved finger.

Odessa Finkelman, an 83-year-old retired librarian, is visiting the primary care group where you practice nursing. She is having constipation difficulties with her colostomy, which was created thirty years ago. She has increased her fluid intake which has slightly lessened her difficulty but she remains constipated. What is another intervention which might make elimination easier?

Eat regular meals

A client received a continent ileostomy 10 days ago, and the surgeon is removing the ileal catheter today. How often should the client empty the reservoir?

Every 2 to 4 hours

When is the best time to irrigate a colostomy?

after meals

A nurse is assessing the stoma of a patient with an ostomy. What would the nurse assess in a normal, healthy stoma?

dark red and moist

A nurse is caring for a client who is scheduled to have a colostomy placed in the transverse section of the large intestine and containing both a proximal and distal stoma. The client will most likely receive which colostomy?

double barrel

A client underwent a continent ileostomy 2 months ago. How often should the client's reservoir be emptied?

every 2-4 hours

A client who underwent a colostomy is discussing lifestyle changes with the nurse. Which of the following statements from the client indicates a need for more teaching?

"I will never be able to travel outside the country again."

A nurse is documenting the appearance of feces from a patient with a permanent ileostomy. Which of the following would she document?

"Ileostomy bag half filled with liquid feces."

A client with Crohn's disease is recovering from a recent total colectomy and ileostomy. The nurse is providing postoperative teaching with the primary focus on how to avoid complications. What would be included in the postoperative teaching?

Chew food into easily digested pieces.

A nurse is caring for a client with chronic ulcerative colitis who is scheduled to have surgery to create an ileoanal reservoir. How would the nurse describe this procedure?

An ileoanal anastomosis is performed in two stages. A temporary ileostomy is performed in the first stage, and 2 to 3 months later, the surgeon closes the temporary ileostomy and reunites the two sections of ileum.

The nurse applies the ostomy appliance to a client who is recovering from ileostomy surgery. Which of the following interventions should a nurse keep in mind to better allow the client to not experience any leakages from their appliance?

Ask client to remain inactive for 5 minutes

The nurse applies the ostomy appliance to a client who is recovering from ileostomy surgery. Which intervention should the nurse keep in mind to avoid any leakages from the appliance?

Ask the client to remain inactive for 5 minutes.

The type of stool that will be expelled into the ostomy bag by a client who has undergone surgery for an ileostomy will be

Liquid consistency

A nurse is providing education to a client with a continent ileostomy. The client asks what should be done if the catheter is obstructed. What would not be included?

Notify health care provider if unable to obtain drainage after 12 hours.

A client with an ileostomy calls the nurse to report that she is experiencing abdominal cramps, vomiting, and watery discharge from her ileostomy. The nurse should:

Notify the physician immediately

A nurse is teaching a client how to irrigate his colostomy. The nurse informs the client that the colostomy should be irrigated for which of the following reasons?

Regulate the timing of bowel movements

A nurse is assisting a client when he is draining a continent ileostomy. The catheter suddenly becomes plugged with stool. Which of the following actions should the nurse take to rectify the problem?

Rotate the catheter tip inside the stoma

The nurse is reviewing an upcoming colostomy procedure with a client. What type of ostomy procedure will the client be undergoing based on the accompanying diagram? A nurse is teaching a client who has undergone a colostomy procedure as depicted in the accompanying image. What type of feces should the client expect to manage? DECENDING

Semi-mushy

A client with a new colostomy tells the nurse she thinks she is ready to learn how to care for it. Which of the following interventions would most likely be effective in preparing the client to look at the colostomy?

Show the client pictures that illustrate how a colostomy looks and functions.

What is the most common type of colostomy that needs to be irrigated to help promote regular evacuation of feces?

Sigmoid colostomy

A nurse is assessing the stoma of a client with an ostomy. Which of the following interventions should the nurse perform when providing peristomal care to the client to preserve skin integrity?

Wash it with soap and water.

In which part of the colon would the nurse expect to see a double-barrel colostomy?

transverse

A nurse is reviewing postprocedure care for a client who has undergone a colostomy procedure. What type of feces should the nurse explain that the client will be managing? TRANSVERSE

MUSHY

A client is receiving postoperative instruction on how to release stool from a newly placed continent ileostomy. Which steps would be included? Select all that apply.

Sit on or beside the toilet, or on the side of the bed. Warm the catheter to body temperature and lubricate the tip.

For 3 weeks, a client's stoma was draining adequate amounts of stool. Several days ago, the nurse began to notice that the client's intestine has begun to telescope through the stoma. The nurse suspects which of the following?

Stomal Prolapse

Nathan Cooper, a 42-year-old police dispatcher, is recovering from the creation of an ileostomy due to complications of a bowel disorder. He has a history of arthritis and takes daily medication to reduce inflammation. What does the physician need to avoid when prescribing medications for Mr. Cooper?

Sustained-release tablets

A nurse is performing an assessment on a client who has returned from colostomy surgery. What action would not be included?

Take the client's temperature via the rectal route and report a sudden elevation in temperature over 101°F.

During your client education with Cindy Keefer, a 53-year-old teacher who has recently had an ostomy created, you discuss the importance of skin care and skin integrity surrounding the stoma. What type of appliance is most appropriate immediately postoperatively?

Temporary

A nurse refers a patient with a new colostomy to a support group. This nurse is practicing which of the following aims of nursing?

facilitating coping

During client education with a client who has recently had an ostomy created, the nurse discusses the importance of skin care and maintaining skin integrity around the stoma. What type of appliance is most appropriate for the immediate postoperative period?

temporary

A client is scheduled to have a conventional ileostomy. A conventional ileostomy involves the removal of:

the entire colon and rectum

A client is in the postoperative phase of an abdominal resection and colostomy. When educating the client on his ostomy care by providing him with educational materials to read, it is important to assess the client's:

vision

A client who underwent a colostomy reports a change in the appearance of his stoma. When the nurse asks for more information, the client says, "I was very upset about some family trouble, and my stoma became deep purple and oozed." How would the nurse respond?

"This is normal as long as the stoma has returned to its usual appearance."

A client who has undergone colostomy surgery is experiencing constipation. Which of the following interventions should a nurse consider for such a client?

Dilate the stoma with a lubricated-gloved finger

Which of the following measures would the nurse recommend to an ostomate to help facilitate a regular bowel pattern without relying on irrigation? Select all that apply.

Drinking prune juice Performing mild exercise Using a stool softner

A common nursing diagnosis for a patient who had a colostomy surgically created 6 months ago would be:

Ineffective Coping impaired due to colostomy

When an appliance is necessary to collect stool from an ostomy, what primarily determines the consistency of the stool that is collected?

Intestinal placement of the stoma

The type of stool that will be expelled into the ostomy bag by a client who has undergone an surgery for an ileostomy will be:

Liquid

Rex Thomas, a 71-year-old author, is returning from colostomy surgery to the surgical unit where you practice nursing. Upon his return you assess his condition and discover he has a double-barrel colostomy. In which part of the colon would you expect to see a double-barrel colostomy?

Transverse

A nurse assessing a patient with an ostomy appliance documents the condition "prolapse" in the patient chart and notifies the physician. Which of the following statements describes this condition?

the stoma is protruding into the bag and may become twisted