Deck 48: Caring for Clients With Ostomies

Question 1

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

Answer 1

Adrenal insufficiency

Question 2

A client who is scheduled for an ileostomy surgery says to the nurse, "I'm afraid I won't be able to look at that stoma." Which response by the nurse would be most therapeutic?

A) "That's something you don't have to think about now."
B) "I'll make sure there is a familiar nurse here with you the first time."
C) "It's okay, everybody feels this anxious about this."
D) "Don't worry, I'm sure that you will be able to do this just fine."

Answer 2

"I'll make sure there is a familiar nurse here with you the first time."

Question 3

A nurse is preparing to administer the prescribed vitamin B12that this is necessary for which reason?

A) Prevent thrombosis
B) Prevent deficiencies
C) Aid proper digestion
D) Prevent constipationto a client who has had most of his ileum removed. The nurse understands

Answer 3

Prevent deficiencies

Question 4

A client has undergone surgery to create a sigmoid colostomy. When inspecting the abdomen, the nurse would expect to find the stoma located in which of the following areas of the abdomen?

A) Middle right
B) Center below the belt line
C) Middle left
D) Lower left

Question 5

A client has undergone ileostomy surgery. The nurse suggests the use of a temporary appliance in the immediate postoperative phase based on which rationale?

A) The size of the stoma changes in the postoperative phase.
B) The client will tolerate a temporary appliance better.
C) A permanent appliance will react with the antibiotics.
D) A temporary appliance minimizes the risk of infection.

Question 6

A client has had surgery to create an ileoanal reservoir surgery. Which instruction would the nurse give to reduce the risk for bowel incontinence?

A) Avoid high-protein food.
B) Take frequent brisk walks.
C) Perform perineal exercises.
D) Perform warm water soaks.

Question 7

A client is scheduled to undergo surgery for an ileostomy. The nurse instructs the client to stop taking which of the following for at least one 1 week before surgery?

A) Corticosteroids
B) Immunosuppressants
C) Aspirin-containing products
D) Antibiotics

Question 8

Which of the following instructions should the nurse include in the teaching plan of a client who has undergone colostomy?

A) Restrict traveling by air.
B) Limit outdoor activities.
C) Avoid tight clothing.
D) Chew food well.

Question 9

Which intervention would be most appropriate for a client who has undergone colostomy surgery?

A) Monitoring vital signs once a day.
B) Taking temperature by rectal route.
C) Monitoring the volume of gastric secretions.
D) Minimizing the client's fluid intake.

Question 10

The nurse is monitoring a client who has had colostomy surgery. Which of the following findings would the nurse need to report to the physician?

A) Urine output of 650 mL in past 24 hours
B) Temperature of 102.6oF (39.2Co)
C) Pain rating of 2 out of 10
D) Clean intact dressingAdd Question Here

Question 11

Which of the following dietary recommendations should the nurse give a client after ostomy surgery to prevent irritation and slow transit time?

A) A low-sodium diet
B) A high-protein diet
C) A high-fat diet
D) A low-fiber diet

Question 12

A client with an ileostomy is receiving medication in a slow-release capsule form. The nurse would be alert for which of the following?

A) Undissolved capsules
B) High blood pressure
C) Decreased urination
D) Presence of blood

Question 13

The nurse is inspecting a client's stoma. Which finding would the nurse need to report to the physician?

A) Bright red color
B) Moist shiny surface
C) Absence of pain sensation
D) Retraction beneath the skin

Question 14

The nurse is assisting a client with a colostomy to change his appliance. After the old appliance and faceplate are removed, which of the following would the nurse assist the client to do next?

A) Empty the pouch.
B) Clean the area with a soapy washcloth.
C) Protect the periostomal area from drainage.
D) Fill in the irregular surfaces in periostomal skin.

Question 15

When caring for a client with ileostomy, the nurse notices that there is a bolus of poorly chewed food in the stool. Which interventions would be most appropriate?

A) Advise the client to chew the food properly.
B) Provide the client with plenty of fluids.
C) Instruct the client to sit upright while eating.
D) Alert the physician about the condition.

Question 16

A client is to undergo a two stage surgery involving a temporary ileostomy and then reuniting of the two sections of ileum 2 to 3 months later. The nurse identifies this type of ostomy as which of the following?

A) Ileoanal reservoir
B) Kock Pouch
C) Single barrel colostomy
D) Loop colostomy

Question 17

A client is to undergo surgery for the creation of a continent ileostomy. Which statement by the client indicates successful teaching?

A) "I'll need to empty the appliance more frequently."
B) "I'll need to learn how to empty the reservoir several times a day"
C) "My stool will be loose initially but then become formed in a week or so."
D) "I'll just push on the valve and the drainage will flow out easily."

Question 18

A client with a colostomy is asking the nurse about what he should and shouldn't eat and drink. Which of the following responses would be appropriate?

A) "Be sure to drink at least 8 to 10 cups of fluid per day."
B) "Eat your large meal in the evening as usual."
C) "Vegetables, like asparagus, help decrease odor."
D) "Eat lots of dried fruits and corn to regulate stool pattern."

Question 19

Which of the following interventions would the nurse need to keep in mind when a loop colostomy of a client is to be opened?

A) Provide the client with plenty of fluids before the procedure.
B) Prepare the client for the pungent odor before the procedure.
C) Elevate the client's legs before and during the procedure.
D) Note the color and amount of fecal material during the procedure.

Question 20

The nurse is assessing the stool consistency of a client with an ascending colostomy. Which of the following would the nurse expect to find?

A) Liquid
B) Semi-liquid
C) Soft
D) Formed

Question 21

A client undergoes surgery for a Kock pouch and returns to the nursing unit. The nurse anticipates that the ileal catheter will be removed in about:

A) 3 to 4 days.
B) 5 to 7 days.
C) 7 to 9 days.
D) 10 to 14 days.

Question 22

A client with an ostomy is receiving instruction about peristomal skin care. Which of the following would be most important to include?

A) Changing the faceplate with each appliance change.
B) Cleaning the area with warm water and soap.
C) Avoiding powder and gel skin pastes.
D) Routinely rub the area vigorously to stimulate circulation.

Question 23

A client with a colostomy asks the nurse for suggestions for foods to help decrease the odor. Which of the following foods would the nurse suggest?

A) Cheese
B) Eggs
C) Garlic
D) Buttermilk

Question 24

After teaching a group of students about the different types of ostomies, the instructor determines that the teaching was successful when the group identifies which of the following as a most likely temporary?

A) Single barrel colostomy
B) Loop colostomy
C) Sigmoid colostomy
D) Double barrel colostomy

Question 25

A nurse is reviewing information about irrigating a colostomy with a client. Which of the following would the nurse emphasize?

A) Using 150 to 300 mL of tepid water for each irrigation
B) Ensuring the bottom of irrigant container about 12 inches above the stoma
C) Advancing the catheter tip 4 to 5 inches into the stoma
D) Stopping the irrigation immediately if the client experiences cramping