Ostomy Care - Module

Which of the following statements indicates that the client understands the strategies that can be used to avoid odorous gas? " well-fitted pouching system with a filter helps prevent odor." "My friend suggested placing aspirin table inside the ostomy pouch." "I'll eat lots of cheese and eggs to minimize odor." "I'll just avoid social situations for an hour or so after I eat gassy foods."

" well-fitted pouching system with a filter helps prevent odor."

Which of the following statements indicates that the client has a good understanding of how to place a new appliance? "I should measure the stoma, then cut the appropriate size before removing the adhesive backing. My stoma will shrink over the next several weeks, so I'll need to measure it regularly." "I should scrub my skin with warm water and dry it completely before applying the new pouching system. It's important for the skin to be dry before application." "After applying the skin barrier, I should use some adhesive remover to be sure any residue is completely gone so that the pouch will adhere properly to the skin barrier. Adherence is important to prevent leakage." "After I place the skin barrier, I should maintain gentle finger pressure around it for a few seconds. Then I can make a pinhole the pouch to prevent gas accumulation before snapping it onto the barrier."

"I should measure the stoma, then cut the appropriate size before removing the adhesive backing. My stoma will shrink over the next several weeks, so I'll need to measure it regularly."

Which of the following psychosocial assessment findings indicates a normal response to the alteration in body function the client had just undergone? Anxiety and refusal to eat. Severe depression, sometimes with suicidal ideation Confidence that life will be back to normal upon discharge home Anger and feelings of loss.

Anger and feelings of loss.

After the surgeon and the enterostomal therapist leave the room, the patient asks, "Why did the doctor say that I am at risk for this complication?" You explain that the risk of suture-line separation increases with which of the following factors? Lower abdominal location Antiplatelet medication. Cardiovascular disease Diabetes mellitus

Diabetes mellitus

Which of the following foods should the client avoid to prevent blockage? Noodles and white bread Cream cheese and bananas Fresh tomatoes and celery Lean meats and poultry

Fresh tomatoes and celery

Which of the following is a likely cause of this electrolyte abnormality? Bleeding High-volume effluent Dehydration Renal failure

High-volume effluent

Which of the following actions should you take first? Flush the area with normal saline solution. Fill in the open space with skin barrier paste. Probe the area to determine the depth of separation. Inspect the circumference of the stoma.

Inspect the circumference of the stoma.

You are working on a medical-surgical unit. One of your clients is a 30-year-old woman transferred from the post-anesthesia care unit after ileostomy surgery for Crohn's disease. You perform a postoperative assessment and find the client alert, oriented, and responding appropriately. However, when you pull down the sheet to observe her abdomen, you observe a serious clinical manifestation. Her ileostomy pouch contains a significant amount of bright red blood. Which of the following types of output is first expected from ileostomy postoperatively? Loose, liquid stools after 1 to 2 days Serous discharge after 6 to 8 hours Formed to semi-formed stool within 2 to 5 days Pasty yellow-brown stool within 3 to 4 days

Loose, liquid stools after 1 to 2 days

Which of the following types of ostomy pouching systems is correct for this client at this time? A pouching system without a skin barrier A one-piece, closed-end pouching system A two-piece pouching system with a pre-cut skin barrier One- or two-piece with a cut-to-fit skin barrier

One- or two-piece with a cut-to-fit skin barrier

Which of the following actions should you take next? Allow the separation to remain open to air for several minutes with the pouch off. Fill in the open space with skin barrier paste. Probe the are to determine the depth of the separation.

Probe the are to determine the depth of the separation.

Which of the following is the best way to treat the separated area? Protect the area using powder and paste. Notify the provider since surgical correction is required. Fill in the "dead space" with an antifungal powder, such as miconazole. Use a convex appliance and stoma belt to prevent leakage of effluent.

Protect the area using powder and paste.

What is the best way to help your patient regain a sense of control and improve her self-esteem? Distract the patient with a book or movie while you provide her ostomy care during her hospital stay. Request her participation in her ostomy care as she is physically able. Encourage your patient to deny her fears, leaving them behind as she moves forward with her new life. Reassure her that she does not need to touch the stoma but encourage her to look at it.

Request her participation in her ostomy care as she is physically able.

Which of the following should also be included in the client's education? Colostomy irrigation An intermittent catheterization schedule Resumption of normal activities, including travel and sex

Resumption of normal activities, including travel and sex

When the patient asks you about any other complications that could result from the separation, which of the following should you explain? Folliculitis Stagnated healing Prolapse Peristomal hernia

Stagnated healing

Which of the following assessments should be your next step? Urine output Stoma

Stoma

Which of the following should you asses next? Urine output Suture line Stoma

Suture line

Which of the following information about peristomal skin care would be correct to tell the client? Colostomy clients have a higher incidence of skin problems than ileostomy clients. The peristomal skin may be slightly red and excoriated. The pouch should be frequently checked for signs of leakage. The most common cause of peristomal skin disorders is chronic illness.

The pouch should be frequently checked for signs of leakage.

Which of the following information should you provide to the client? With a one-piece system, the pouch and skin barrier are permanently attached. With a two-piece system, the pouch may be detached while the skin barrier remains around the stoma. A one-piece system does not include a skin barrier. A two-piece system includes a skin barrier pouch. A one-piece system allows the skin barrier to remain in plave around the stoma for several days. A two-piece system does not allow this. With a one-piece system, the pouch must always be used with the manufacturer's skin barrier. With a two-piece system, the client can use any skin barrier with any pouch.

With a one-piece system, the pouch and skin barrier are permanently attached. With a two-piece system, the pouch may be detached while the skin barrier remains around the stoma.