The registered nurse is developing a nursing care plan for a client who has just undergone surgery for treatment of ulcerative colitis with the creation of a permanent ileostomy. What is the priority outcome for this client?

Question

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A client who has undergone ostomy surgery must become independent in self-care. This requires adaptation to a significant alteration in body image and dealing with a number of psychosocial issues that are associated with a change in appearance and the loss of bowel control. It is not uncommon for a client to cope with this loss by refusing to look at or participate in the care of the stoma. Nursing interventions for this client will include: Supportive counseling and assistance in psychosocial adjustment Teaching and facilitating self-care Providing information about the reason for the surgery, prognosis, potential complications, and community resources The priority outcome of nursing care is that the client will look at and touch the stoma; this is an indication that the client has accepted or begun to accept the change in body image and functioning and can begin participating in self-care. (Option A) This is an appropriate outcome; community organizations can offer support and educational materials to the client; however, it is not the priority. (Option C) This is an appropriate outcome, but as a passive activity, it is not a strong indicator that the client is ready for self-care. (Option D) This is an appropriate outcome as it indicates effective ostomy teaching; however, it is not the priority. Teaching will be more effective once the client has accepted the ostomy. Educational objective: A client with a change in body image and functioning, such as the creation of an ostomy, will need to adapt to and cope with the significant changes. Support and teaching will assist the client in overcoming psychosocial barriers to self-care; performance of a desired action is the strongest indicator of learning and acceptance.

The Registered Nurse Is Developing a Nursing Care Plan for a Client