A nurse is providing teaching to a client who has a new colostomy.
Which of the following actions should the nurse take when demonstrating how to change the ostomy appliance?

Apply the skin sealant on damp skin.

Remove the appliance before emptying the pouch.

Ensure that the skin is slightly damp for better adhesion of the pouch.

Trace the size of stoma onto the skin barrier.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Applying skin sealant on damp skin is not a correct technique when changing an ostomy appliance. Skin should be clean and thoroughly dry before applying any ostomy products. Moisture on the skin can interfere with the adhesion of the pouching system, leading to skin irritation and leakage.

Choice B rationale:

Removing the appliance before emptying the pouch is not the correct technique. Ostomy pouches are designed to be emptied without removing the entire appliance. Removing the pouch unnecessarily can cause discomfort to the client and may damage the surrounding skin. Regular emptying of the pouch while leaving the appliance in place is the appropriate practice.

Choice C rationale:

Ensuring that the skin is slightly damp for better adhesion of the pouch is not accurate. Ostomy pouches adhere best to clean, dry skin. Moisture on the skin can compromise the adhesive seal and lead to skin irritation. Therefore, the skin should be thoroughly dried before applying the ostomy pouching system.

Choice D rationale:

Tracing the size of the stoma onto the skin barrier is the correct technique when changing an ostomy appliance. The opening of the skin barrier (wafer) should match the size and shape of the stoma to ensure a proper fit. Tracing the stoma's size onto the barrier helps in cutting the opening to the appropriate size, preventing leakage and ensuring a secure fit around the stoma.

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Correct Answer is A

Explanation

The correct answer is A. Increased pain.

Choice A reason: Naloxone is an opioid antagonist that, when administered, reverses the effects of opioids. Since opioids provide analgesia, their reversal will lead to the return of pain sensation. The normal pain response varies widely among individuals and depends on the type and amount of opioid the patient received, as well as their pain threshold and tolerance.

Choice B reason: Somnolence, or drowsiness, is a common effect of opioid administration. Naloxone works by displacing opioids from their receptors, which should counteract the sedative effects of opioids and reduce somnolence. Therefore, after naloxone administration, the nurse should not expect somnolence as a finding.

Choice C reason: Hyperglycemia, or high blood sugar, is not a direct effect of naloxone administration. While some studies suggest that naloxone may affect blood glucose levels under certain conditions, such as in the case of tramadol overdose, it does not typically cause hyperglycemia. Normal blood glucose levels range from 70 to 99 mg/dL fasting, and up to 140 mg/dL two hours after eating.

Choice D reason: Hypoventilation, or reduced breathing rate and depth, is caused by opioid administration. Naloxone’s role is to reverse this effect, restoring normal breathing rates. The normal respiratory rate for a healthy adult at rest is 12 to 20 breaths per minute.

A. Naproxen. B. Magnesium hydroxide. C. Lisinopril. D. Propranolol.

Correct Answer is A

Explanation

Choice A rationale:

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) and can increase the risk of bleeding when used with warfarin, which is an anticoagulant medication. Combining these two medications can lead to excessive bleeding and is considered incompatible.

Choice B rationale:

Magnesium hydroxide is an antacid and does not have significant interactions with warfarin. It does not affect the anticoagulant properties of warfarin.

Choice C rationale:

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure and heart failure. It does not have a significant interaction with warfarin.

Choice D rationale:

Propranolol is a beta-blocker used to treat high blood pressure, angina, and other heart conditions. It does not have a significant interaction with warfarin.

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A nurse is providing teaching to a client who has a new colostomy.Which of the following actions should the nurse take when demonstrating how to change the ostomy appliance?

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A nurse is providing teaching to a client who has a new colostomy.
Which of the following actions should the nurse take when demonstrating how to change the ostomy appliance?