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Which nursing action is essential to reduce the patient’s risk of developing a postsurgical infection at the site of a permanent colostomy?
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Change the dressing as ordered by the surgeon.
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Administer intravenous antibiotics as prescribed.
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Assesse the patient’s understanding of the importance of infection control measures.
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Instruct the patient in the proper technique for handling hygiene of the colostomy site.
\
\
The nurse would assess for which risk factor in a patient hospitalized for a strangulated intestinal hernia?
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Abdominal surgery
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Hyperlipidemia
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Intestinal infarctions
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Family history
\
\
\
A patient is being assessed for a possible bowel obstruction. The nurse provides information regarding which diagnostic tests to confirm the presence of an obstruction?
(Select all that apply.)
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
\
Barium swallow
\
A CT scan of the abdomen
\
An abdominal X-ray series
\
Serum osmolality
\
CBC with differential
\
The nurse is caring for a patient with a jejunostomy tube. Which statement by the nurse indicates the need for additional information to safely manage the medical intervention?
\
“I will keep the patient on bed rest until the tube can be removed.”
\
“It’s my habit to irrigate the jejunostomy tube just prior to administering the patient’s sleeping medication.”
\
“A pH of 5 or less indicates the tube is in the stomach, not the intestine.”
\
“I plan to assess the patient’s abdomen for distention at regular intervals.”
\
\
\
A patient who has had gastric surgery that affected the effectiveness of the alimentary system will be fed via a gastrostomy tube upon discharge to home. How would the nurse explain the rationale for this intervention?
\
A gastrostomy tube is less invasive than a jejunostomy tube.
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Gastrostomy tubes are more cost effective than nasogastric feeding.
\
Gastrostomy feeding is less likely to produce side effects than parenteral nutrition.
\
Gastrostomy feeding is more supportive of the specialized diet the patient will require.
\
What information should the nurse provide a patient regarding the patient’s newly created permanent ileostomy?
\
An additional surgery will be required in 2 to 3 months.
\
The stoma will initially produce dark green fecal matter.
\
The stoma should not produce any bloody discharge.
\
Because the condition required a gastroduodenostomy (Billroth I), an ileostomy was also necessary.
\
\
\
\
What information should the nurse provide for the patient with a newly created Kock ileostomy (continent ileostomy)?
(Select all that apply.)
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
\
The stoma will be reversed when the bowels have had the time to heal.
\
Fecal matter will be removed by a catheter inserted through the stoma.
\
A nipple valve was created to control the flow of fecal matter.
\
The stoma should appear pink and moist.
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The surgery involved manipulating a portion of the terminal ileum.
\
\
A patient with Crohn’s disease is demonstrating the nursing diagnosis Imbalanced Nutrition: Less than Body Requirements. What intervention should the nurse include in this patient’s plan of care?
\
A low-calorie, high-milk diet
\
A low-calorie, low-residue diet
\
The DASH diet
\
A normal, well-balanced diet
\
\
\
A patient with Crohn’s disease is recovering from a bowel resection. What information should the nurse provide?
\
“Surgery has ensured that you will never have another recurrence of the disease.”
\
“You need close follow-up because there is a possibility of recurrence in another portion of the bowel.”
\
“You may develop ulcerative colitis now that your Crohn’s is cured.”
\
“The surgery increases your risk of developing an intestinal stricture.”
\
\
\
A patient learns that a small bowel obstruction was caused by an appendectomy 5 years ago. How would the nurse explain this development to the patient?
\
“The infection in your appendix should have been treated earlier.”
\
“Abdominal surgery sometimes results in adhesion or scarring of tissues that can result in bowel obstruction.”
\
“You must have had an undiagnosed femoral hernia at the time of your appendectomy.”
\
“The surgeon did not irrigate your abdomen adequately when you had your appendectomy.”
\
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