A nurse is providing discharge teaching for a client who had a partial colectomy 2 days ago. Which of the following information should the nurse include in the teaching?

"Place an aspirin in your ostomy pouch to control odor."

"Your ostomy should start functioning in five days."

"Empty your ostomy pouch when it becomes a third to halfway full."

"Notify your provider if your stoma becomes dark red:"

Answer and Explanation

The Correct Answer is C

A. "Place an aspirin in your ostomy pouch to control odor.": Aspirin should never be placed in an ostomy pouch, as it can damage the pouch material and irritate the stoma. Deodorizers or dietary adjustments are safer alternatives for odor control.

B. "Your ostomy should start functioning in five days.": An ostomy typically begins functioning within 2 to 4 days postoperatively, depending on bowel motility. Waiting five days without output could indicate an obstruction or ileus, requiring medical evaluation.

C. "Empty your ostomy pouch when it becomes a third to halfway full.": Keeping the pouch from becoming too full prevents leaks, discomfort, and excessive pressure on the stoma. This practice helps maintain skin integrity and ostomy function.

D. "Notify your provider if your stoma becomes dark red.": A dark red stoma is normal and indicates good blood supply. However, a stoma that turns pale, dusky, or black requires immediate medical attention, as it suggests compromised circulation and possible necrosis.

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Correct Answer is D

Explanation

A. Use fluticasone as needed for shortness of breath: Fluticasone is a corticosteroid used for long-term inflammation control in COPD, not for immediate symptom relief. Short-acting bronchodilators like albuterol are used for acute shortness of breath.

B. Limit fluid intake to 1 L per day: COPD clients benefit from adequate hydration (typically 2-3 L per day) to help thin mucus secretions and improve airway clearance. Restricting fluids can lead to thickened secretions and increased respiratory distress.

C. Avoid use of pursed-lip breathing: Pursed-lip breathing is encouraged for COPD clients to help reduce air trapping, improve oxygenation, and promote more effective exhalation. It is an essential technique for managing dyspnea.

D. Obtain a yearly influenza immunization: COPD clients are at higher risk of complications from respiratory infections. An annual influenza vaccine helps reduce the risk of severe illness and exacerbations, making it a crucial part of COPD management.

A. WBC 12,000/mm3 (5,000 to 10,000/mm3) B. 25-Hydroxyvitamin D 92 ng/mL (25 to 80 ng/mL) C. Hgb 18 g/dL (12 to 16 g/dL) D. Albumin 3.1 g/dL (3.5 to 5 g/dL)

Correct Answer is D

Explanation

A. WBC 12,000/mm³ (5,000 to 10,000/mm³): An elevated white blood cell count suggests inflammation or infection, but it does not directly indicate an increased risk for skin breakdown. Skin integrity is more affected by nutritional status, mobility, and pressure exposure.

B. 25-Hydroxyvitamin D 92 ng/mL (25 to 80 ng/mL): This level is within the normal range and does not contribute to an increased risk for skin breakdown. Adequate vitamin D supports bone health and immune function, but protein levels and overall nutrition play a more direct role in skin integrity.

C. Hgb 18 g/dL (12 to 16 g/dL): A hemoglobin level above the normal range suggests polycythemia, which can increase blood viscosity. However, it does not directly correlate with skin breakdown risk. Lower hemoglobin levels, indicating anemia, are more likely to impair wound healing.

D. Albumin 3.1 g/dL (3.5 to 5 g/dL): A low albumin level reflects poor protein status, which is a key risk factor for skin breakdown. Protein is essential for tissue repair and maintaining skin integrity, and hypoalbuminemia is commonly associated with increased susceptibility to pressure injuries in immobile clients.

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A nurse is providing discharge teaching for a client who had a partial colectomy 2 days ago. Which of the following information should the nurse include in the teaching?

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