A nurse is educating a patient on how to irrigate an ostomy bag. Which statement by the patient indicates the need for further instruction?

"I should never attempt to reach into my stoma to remove fecal material."

"Using warm enema will reduce cramping and discomfort during the procedure."

"To properly irrigate and clean my ostomy stoma, I can use any solution that is convenient."

"Sitting on the toilet lets the ostomy bag and irrigant drain into the toilet bowl."

Answer and Explanation

The Correct Answer is C

Choice A This statement is correct, as patients should never attempt to insert anything into the stoma to remove fecal material.

Choice B This statement is also correct, as using warm water for irrigation can help reduce discomfort and cramping during the procedure.

Choice C This statement is incorrect. Patients should use only the irrigation solution recommended by their healthcare provider, as using the wrong solution can lead to complications or damage to the stoma.

Choice D This statement is correct, as sitting on the toilet allows the ostomy bag and irrigation solution to drain directly into the toilet, making the procedure more convenient.

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Correct Answer is A

Explanation

A. When the left descending colon and rectum are removed, a colostomy is typically created. This involves bringing the proximal end of the remaining colon to the surface of the abdomen to create a stoma. The colostomy allows the rest of the bowel to heal and function normally.

B.A continent ostomy involves creating an internal reservoir with a valve, allowing the patient to control the evacuation of intestinal contents. This option is less common and usually associated with continent ileostomies rather than temporary diversions to rest a portion of the colon.

C. A Kock pouch is a type of continent ileostomy where an internal reservoir is created from the ileum, and the patient can empty the reservoir with a catheter. This is not typically used as a diversion for healing purposes involving the colon.

D.An ileostomy involves bringing the end of the ileum (the last part of the small intestine) to the surface of the abdomen to create a stoma. Given that the left descending colon and rectum were removed, this procedure is unlikely unless the entire colon is bypassed or removed, which is not specified in this scenario.

A. "Sometimes severe stress can make the stool bright red." B. "This is probably nothing. Just let me know if it happens again." C. "This needs to be investigated. I will need a stool sample immediately and need to notify the Charge RN." D. "You should schedule a colonoscopy as soon as possible."

Correct Answer is A

Explanation

Choice A: Bright red stool can be caused by various factors, including the consumption of certain foods, medications, or gastrointestinal bleeding. Stress can lead to changes in bowel movements and might cause bright red stool due to increased gastrointestinal motility.

Choice B: While it's essential to reassure the patient, dismissing their concern without further assessment is not appropriate. The nurse should still investigate the potential causes of bright red stool.

Choice C: Jumping to conclusions and ordering immediate tests without further assessment is not the best approach. Before taking any action, the nurse should gather more information and assess other possible causes.

Choice D: Suggesting a colonoscopy as the first step is not necessary for every case of bright red stool. Further assessment is needed to determine the cause before resorting to such an invasive procedure.

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A nurse is educating a patient on how to irrigate an ostomy bag. Which statement by the patient indicates the need for further instruction?

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