A nurse is teaching a dent who is preoperative for a sigmoid colostomy. Which of the following statements should the nurse include?

"Your colostomy will not produce formed steel.”

"You will have a stoma in your left lower abdomen.”

"You should expect your store to be a purple color."

“The end of the stoma will be painful after this procedure.”

Answer and Explanation

The Correct Answer is B

A. "Your colostomy will not produce formed stool.” A sigmoid colostomy produces formed stool because it is at the end of the large intestine, where water is absorbed.

B. "You will have a stoma in your left lower abdomen." A sigmoid colostomy is placed in the left lower quadrant (LLQ) of the abdomen.

C. "You should expect your stoma to be a purple color." A healthy stoma should be pink to red and moist. A purple, dusky, or dark-colored stoma may indicate ischemia and requires immediate evaluation.

D. "The end of the stoma will be painful after this procedure." The stoma itself does not have nerve endings, so it should not be painful. However, the surrounding abdominal incision may be sore.

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Correct Answer is B

Explanation

A. Weight loss and malnutrition: IBS does not typically cause weight loss or malnutrition. If a client experiences these symptoms, further evaluation is needed to rule out other conditions such as inflammatory bowel disease (IBD) or malignancy.

B. Alteration between constipation and diarrhea: IBS is characterized by a change in bowel habits, which may include alternating episodes of constipation and diarrhea. This is the correct answer.

C. Severe rectal bleeding: IBS does not cause rectal bleeding. If present, conditions such as hemorrhoids, IBD, or colorectal cancer should be considered.

D. Fever and elevated white blood cell count: IBS does not cause systemic inflammation. Fever and leukocytosis are more indicative of infections or inflammatory disorders like ulcerative colitis or Crohn's disease.

A. Maintain a patent airway and prevent aspiration B. Monitor the effects of ant-hypertensive medications C. Prepare the client for immediate portal shunting surgery D. Perform fecal occult testing on all stools

Correct Answer is B

Explanation

A. Maintain a patent airway and prevent aspiration: While maintaining a patent airway is always important, esophageal varices do not typically cause aspiration unless they rupture. This choice would be a priority in an acute bleed, not in a stable client.

B. Monitor the effects of antihypertensive medications: Beta-blockers (e.g., propranolol) are commonly prescribed to reduce portal hypertension, preventing variceal rupture. Monitoring the effects of these medications is crucial in maintaining hemodynamic stability.

C. Prepare the client for immediate portal shunting surgery: Surgical shunting is considered for refractory cases with severe, recurrent bleeding. A client with stable varices does not require immediate surgery.

D. Perform fecal occult testing on all stools: Esophageal varices cause upper GI bleeding, which manifests as hematemesis or melena, not occult blood in the stool.

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A nurse is teaching a dent who is preoperative for a sigmoid colostomy. Which of the following statements should the nurse include?

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