A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?
Intestinal obstruction
Folate deficiency
Malabsorption of fat
Fluid and electrolyte imbalance
The Correct Answer is D
Choice A Reason: This is incorrect because intestinal obstruction is not a common complication of ileostomy surgery. An ileostomy is a surgical opening in the abdomen that connects the end of the small intestine (ileum) to a pouch or bag outside the body. This allows stool to bypass the colon and rectum. Intestinal obstruction can occur if there is a blockage or narrowing in any part of the digestive tract, but it is more likely to affect the colon than the ileum.
Choice B Reason: This is incorrect because folate deficiency is not a common complication of ileostomy surgery. Folate is a vitamin that is essential for DNA synthesis and cell division. Folate is mainly absorbed in the jejunum, which is the middle part of the small intestine. An ileostomy does not affect the jejunum, so it does not interfere with folate absorption.
Choice C Reason: This is incorrect because malabsorption of fat is not a common complication of ileostomy surgery. Fat is digested and absorbed in both the small and large intestine. An ileostomy does not affect fat digestion, but it may reduce fat absorption by decreasing the transit time and surface area of the intestine. However, this is usually not significant enough to cause malabsorption symptoms.
Choice D Reason: This is correct because fluid and electrolyte imbalance is a common complication of ileostomy surgery. Fluid and electrolytes are mainly absorbed in the colon, which is bypassed by an ileostomy. This can result in increased fluid and electrolyte loss through stool, especially sodium and potassium. This can lead to dehydration, hypotension, weakness, cramps, or arrhythmias.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E","F"]
Explanation
Choice A reason: This is incorrect because the nurse should not include this in the postoperative education to the client. The client should not drive home after glaucoma surgery, as they will have reduced vision and increased sensitivity to light in the operated eye. The nurse should advise the client to arrange for someone else to drive them home.
Choice B reason: This is incorrect because the nurse should not include this in the postoperative education to the client. The client should not lie on the right side when going to bed, as this can put pressure on the operated eye and increase the risk of bleeding or infection. The nurse should advise the client to sleep on their back or on their left side.
Choice C reason: This is correct because the nurse should include this in the postoperative education to
the client. The client should report flashing lights, as this can indicate a complication such as retinal detachment or vitreous hemorrhage. The nurse should instruct the client to call the provider immediately if they see flashing lights.
Choice D reason: This is incorrect because the nurse should not include this in the postoperative education to the client. The client should not nap on their left side when they get home, as this can cause fluid accumulation and increased intraocular pressure in the operated eye. The nurse should advise the client to elevate their head at least 30 degrees when resting.
Choice E reason: This is correct because the nurse should include this in the postoperative education to
the client. The client should avoid housework like vacuuming, as this can cause bending, lifting, or straining that can increase intraocular pressure and affect wound healing. The nurse should advise the client to limit physical activity and follow the provider's instructions on when to resume normal activities.
Choice F reason: This is correct because the nurse should include this in the postoperative education to
the client. The client may see flashes of light in the operated eye, as this is a normal phenomenon caused by stimulation of the retina by gas bubbles or fluid shifts. The nurse should reassure the client that flashes of light are normal and will subside over time.
Correct Answer is B
Explanation
Choice A Reason: This is incorrect because full vision loss in one eye does not necessarily mean that the person is legally blind. Legal blindness depends on the visual acuity and visual field of both eyes.
Choice B Reason: This is correct because legal blindness is defined by the World Health Organization (WHO) as having a visual acuity of 20/200 or worse in the better eye with the best possible correction, such as glasses or contact lenses. This means that the person can see at 20 feet what a normal person can see at 200 feet.
Choice C Reason: This is incorrect because inability to see clearly from 200 feet away without corrective lenses may indicate nearsightedness or myopia, but not legal blindness. Nearsightedness can be corrected with lenses or surgery.
Choice D Reason: This is incorrect because bilateral visual impairment of 20/60 or greater does not meet the criteria for legal blindness. Visual impairment is defined by WHO as having a visual acuity of less than 20/60 but better than 20/200 in the better eye with the best possible correction.
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