A patient asks if rectal suppositories can be used to assist with constipation problems with his colostomy. What should the nurse clarify regarding suppositories?

Rationale:

A. Piercing the colostomy pouch is dangerous and can lead to leakage, contamination, and infection. It also defeats the purpose of the pouch, which is to contain waste and control odor. Modern pouches often have built-in filters to safely release gas without allowing odor to escape.

B. Tight-fitting underwear does not prevent odor. Instead, it can trap gas and moisture, potentially increasing odor and causing skin irritation or breakdown around the stoma. Properly fitting undergarments are important for comfort but are not effective for odor control.

C. While older methods suggested rinsing pouches with vinegar, this is unnecessary with modern disposable or closed-system pouches. Improper rinsing can compromise the pouch seal, reduce its effectiveness, and irritate the skin.

D. Maintaining proper hygiene around the stoma is the safest and most effective way to control odor. This includes regularly emptying the pouch before it becomes too full, gently cleaning the peristomal skin, changing the pouch as needed to prevent leaks and bacterial growth, and using deodorizing drops or odor-filter pouches if recommended. Proper hygiene reduces bacterial growth, minimizes odor, prevents skin irritation, and helps alleviate patient anxiety, improving quality of life.

Rationale:

A. Bone marrow stimulants do not affect how chemotherapy is absorbed or distributed in the bones. Their purpose is not related to drug delivery, so this option is incorrect.

B. These medications do not directly strengthen bone tissue. While cancer can weaken bones, bone marrow stimulants focus on blood cell production, not bone density. Treatments for bone strengthening might include bisphosphonates or calcium/vitamin D supplementation, which are different from marrow stimulants.

C. Bone marrow stimulants, also called colony-stimulating factors (CSFs), are used to increase the production of white blood cells in the bone marrow. This helps boost the immune system, particularly neutrophils, which are often reduced by chemotherapy (neutropenia). Enhancing white blood cell counts reduces infection risk and supports the patient’s ability to tolerate cancer treatment safely.

D. Bone marrow stimulants cannot prevent chemotherapy-induced damage to the marrow. They work after damage occurs to stimulate blood cell production but do not provide protection or shielding against chemotherapy toxicity.