A patient with Crohn's disease underwent a procedure to remove a portion of the large intestine. The distal portion of the colon was removed, allowing it time to rest and heal. A nurse identifies that this type of bowel diversion is known
Colostomy.
Continent ostomy.
Kock pouch.
Ileostomy.
The Correct Answer is A
A. When the left descending colon and rectum are removed, a colostomy is typically created. This involves bringing the proximal end of the remaining colon to the surface of the abdomen to create a stoma. The colostomy allows the rest of the bowel to heal and function normally.
B. A continent ostomy involves creating an internal reservoir with a valve, allowing the patient to control the evacuation of intestinal contents. This option is less common and usually associated with continent ileostomies rather than temporary diversions to rest a portion of the colon.
C. A Kock pouch is a type of continent ileostomy where an internal reservoir is created from the ileum, and the patient can empty the reservoir with a catheter. This is not typically used as a diversion for healing purposes involving the colon.
D. An ileostomy involves bringing the end of the ileum (the last part of the small intestine) to the surface of the abdomen to create a stoma. Given that the left descending colon and rectum were removed, this procedure is unlikely unless the entire colon is bypassed or removed, which is not specified in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Laxatives might be an option, but they should not be the first intervention. Other noninvasive measures should be tried first.
Choice B Administering a cleansing enema is not the first intervention for a patient having
trouble defecating into a bedpan. It is an invasive procedure and should be considered after less invasive measures have been tried.
Choice C Withholding pain medication might lead to unnecessary discomfort for the patient and is not the best approach to promote bowel movements.
Choice D Raising the head of the bed will help the patient assume a more upright position, which can facilitate bowel movement and defecation into the bedpan more effectively.
Correct Answer is D
Explanation
Choice A: Holding the enema for only 5 minutes may not provide enough time for the mineral oil to soften the stool and facilitate a bowel movement.
Choice B Holding the enema for 60 minutes is unnecessary and can lead to discomfort and difficulty for the patient.
Choice C Holding the enema for only 1 minute is too short for the mineral oil to be effective in softening the stool.
Choice D Encouraging the patient to hold the mineral oil enema for a minimum of 15 minutes allows sufficient time for the oil to work on the stool and improve the chances of a successful bowel movement.
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