Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
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Chapter 48, Caring for Clients With Ostomies
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 48. | 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 |
| Ans: | D |
| Feedback: | |
| Adrenal crisis is potentially life threatening and may result from the abrupt withdrawal of corticosteroids. Therefore, the nurse should closely monitor a client who is scheduled for an ileostomy surgery for adrenal insufficiency, resulting from corticosteroid withdrawal. Withdrawal of corticosteroids does not cause cerebral anoxia, cardiac dysrhythmias, or hypothyroidism. |
| 2. | 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. |
| Ans: | B |
| Feedback: | |
| When the loop colostomy of a client is to be opened, the nurse should prepare the client for the pungent odor of cauterized tissue before the procedure. Intake of fluid and elevation of the legs have no implications in such a procedure. There is an initial gush of fecal material during the procedure. However, the nurse need not note the color and amount of fecal material passed. |
| 3. | 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. |
| Ans: | C |
| Feedback: | |
| The nurse should monitor the volume of suctioned gastric secretions in a client who has undergone colostomy surgery. The nurse should monitor vital signs once every 4 hours and take temperature by any route other than rectal. The nurse should also ensure that the client’s fluid intake is adequate and not minimized. |
| 4. | A nurse is preparing to administer the prescribed vitamin B12 to a client who has had most of his ileum removed. The nurse understands that this is necessary for which reason? |
| A) | Prevents thrombosis |
| B) | Prevents deficiencies |
| C) | Aids proper digestion |
| D) | Prevents constipation |
| Ans: | B |
| Feedback: | |
| Parenteral injections or intranasal administrations (Nascobal) of vitamin B12 are used to prevent deficiencies in clients who have had most or all of the ileum removed because this area is responsible for B12 absorption. Vitamin B12 does not prevent thrombosis or constipation or aid digestion. |
| 5. | 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. |
| Ans: | D |
| Feedback: | |
| The nurse should instruct a client who has undergone colostomy to chew food properly. This helps decrease gas that results chiefly from swallowing air rather than from digestion. The client need not limit or avoid traveling or outdoor activities. If traveling by air, the nurse should instruct the client to take ostomy supplies in carry-on luggage to prevent their loss if luggage is misdirected or lost. If the client requires firm tight support, he or she should find a stoma shield to help prevent irritation or undue pressure on the stoma. |
Original price was: $100.00.$75.00Current price is: $75.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $100.00.$75.00Current price is: $75.00.
Original price was: $30.00.$20.00Current price is: $20.00.
