The Client with an Ileostomy
The nurse should instruct a client who is scheduled for an ileostomy to do which of the following 2 weeks before surgery? a) Stop taking drugs that will interfere with clotting (aspirin, ibuprofen). b) Follow a low-residue diet. c) Abstain from having sex. d) Wear a mask when in public to prevent infection
A
The nurse finds the client who has had an ileostomy crying. The client explains to the nurse,"I'm upset because I know I won't be able to have children now that I have an ileostomy." Which of the following would be the best response for the nurse? a) "Many women with ileostomies decide to adopt. Why don't you consider that option?" b) "Having an ileostomy does not necessarily mean that you can't bear children. Let's talk about your concerns." c) "I can understand your reasons for being upset. Having children must be important to you." d) "I'm sure you will adjust to this situation with time. Try not to be too upset."
B
The nurse is teaching the client how to care for an ileostomy. The client asks the nurse how long to wear the pouch before changing it. The nurse should tell the client which of the following? a) "The pouch is changed only when it leaks." b) "You can wear the pouch for about 4 to 7 days." c) "You should change the pouch every evening before bedtime." d) "It depends on your activity level and your diet
B
A client is scheduled for an ileostomy. Which of the following interventions would be most helpful in preparing the client psychologically for the surgery? a) Include family members in preoperative teaching sessions. b) Encourage the client to ask questions about managing an ileostomy. c) Provide a brief, thorough explanation of all preoperative and postoperative procedures. d) Invite a member of the ostomy association to visit the client.
C
Immediately after having surgery to create an ileostomy, which goal has the highest priority? a) Providing relief from constipation. b) Assisting the client with self-care activities. c) Maintaining fluid and electrolyte balance. d) Minimizing odor formation.
C
The client asks the nurse, "Is it really possible to lead a normal life with an ileostomy?" Which action by the nurse would be the most effective to address this question? a) Have the client talk with a member of the clergy about these concerns. b) Tell the client to worry about those concerns after surgery. c) Arrange for a person with an ostomy to visit the client preoperatively. d) Notify the surgeon of the client's question.
C
The nurse should instruct the client with an ileostomy to report which of the following immediately? a) Passage of liquid stool from the stoma. b) Occasional presence of undigested food in the effluent. c) Absence of drainage from the ileostomy for 6 or more hours. d) Temperature of 99.8°F (37.7°C).
C
Three weeks after the client has had an ileostomy, the nurse is following up with instruction about using a skin barrier around the stoma at all times. The client has been applying the skin barrier correctly when: a) There is no odor from the stoma. b) The client is adequately hydrated. c) There is no skin irritation around the stoma. d) The client only changes the ostomy pouch once a day.
C
Which of the following statements about ileostomy care indicates that the client understands the discharge instruction? a) "I should be able to resume weight lifting in 2 weeks." b) "I can return to work in 2 weeks." c) "I need to drink at least 3,000 mL a day of fluid." d) "I will need to avoid getting my stoma wet while bathing."
C
A client with a well-managed ileostomy has sudden onset of abdominal cramps, vomiting, and watery discharge from the ileostomy. The nurse should: a) Tell the client to take an antiemetic. b) Encourage the client to increase fluid intake to 3 L/day to replace fluid lost through vomiting. c) Instruct the client to take 30 mL of milk of magnesia to stimulate a bowel movement. d) Notify the physician.
D
