A nurse is providing preoperative teaching about stool consistency to a client who will undergo a colectomy with the placement of an ileostomy. Which of the following information about stool consistency should the nurse include in the teaching?

The stool will have a tarry color.

The stool will have a high volume of liquid.

The stool will be solid and well-formed.

The stool will appear bloody with clots.

Answer and Explanation

The Correct Answer is B

Rationale:
A. The stool will have a tarry color: Tarry stools typically indicate the presence of digested blood from upper gastrointestinal bleeding. This is not expected after an ileostomy, which involves the small intestine, not the upper GI tract.

B. The stool will have a high volume of liquid: After a colectomy with ileostomy placement, stool bypasses the colon, where most water reabsorption occurs. As a result, the output from an ileostomy is typically frequent and liquid or semi-liquid in consistency.

C. The stool will be solid and well-formed: Solid, well-formed stools are characteristic of a functioning colon. Because the colon is removed in a colectomy with ileostomy, stool will not be solid due to the lack of water absorption.

D. The stool will appear bloody with clots: Bloody stools with clots suggest active bleeding, which is not expected in normal postoperative ileostomy output. This would be an abnormal finding and should be reported immediately.

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Correct Answer is D

Explanation

Rationale:
A. Decreased calcium levels: Hypocalcemia may cause neuromuscular symptoms such as tetany or tingling but is not associated with exophthalmos (protruding eyes). Calcium imbalance does not typically cause changes in eye appearance.

B. Decreased somatotropin levels: Somatotropin (growth hormone) deficiency may lead to growth delay or reduced muscle mass, but it is not associated with changes in orbital appearance. Protruding eyes are unrelated to growth hormone levels.

C. Increased glucose levels: Elevated glucose is characteristic of diabetes mellitus and may lead to complications like neuropathy or retinopathy, but it does not cause eye protrusion.

D. Increased T4 levels: Elevated thyroxine (T4) is seen in hyperthyroidism, particularly in Graves' disease, which is strongly associated with exophthalmos. The protrusion results from inflammation and edema of orbital tissues, a hallmark of this thyroid disorder.

A. Chest tube output B. Respiratory rate C. Trachea position D. Urine output E. O₂ saturation F. Blood pressure G. Heart rate H. Temperature

Correct Answer is ["A","C","E","F"]

Explanation

Rationale:

Chest tube output: A sudden stop in chest tube drainage following bright red output earlier can indicate tube obstruction or clot formation. This is concerning post-lobectomy, as blocked drainage may lead to tension pneumothorax or fluid accumulation.
Respiratory rate: A rate of 18/min is within normal limits and shows no signs of distress or compromise. Therefore, it does not require immediate reporting.
Trachea position: A shift from midline to deviated trachea suggests mediastinal shift, potentially due to a developing tension pneumothorax. This is a medical emergency and must be reported immediately.
Urine output: A urine output of 110 mL over one hour is well within normal limits and indicates adequate kidney perfusion. The expected minimum is 30 mL/hr, so this value does not raise concern for hypoperfusion or renal impairment. There is no need to report this finding to the provider at this time.
O₂ saturation: A drop from 92% to 89% on room air is clinically significant, especially after thoracic surgery. Hypoxia in this context may signal impaired lung function or emerging complications like pneumothorax.
Blood pressure: The client’s blood pressure dropped from 130/80 mm Hg to 110/60 mm Hg within one hour. While 110/60 mm Hg is still within normal range, the sudden 20 mm Hg drop in systolic pressure may indicate early hemodynamic instability, especially postoperatively.
Heart rate: A heart rate of 70/min is normal and stable, showing no signs of bradycardia or tachycardia that would warrant concern at this stage.
Temperature: A decrease in temperature from 37.2°C to 36.4°C is not clinically alarming postoperatively and does not suggest infection or hypothermia. No need for immediate reporting.

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A nurse is providing preoperative teaching about stool consistency to a client who will undergo a colectomy with the placement of an ileostomy. Which of the following information about stool consistency should the nurse include in the teaching?

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