The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care.

What is the nurse's most appropriate response to this observation?

Remind the patient that they will be responsible for caring for the ileostomy after discharge.

Reassure the patient that this procedure will be reversed in a few months.

Acknowledge the patient's reluctance and initiate discussion to explore their feelings.

Discuss with the medical team during interdisciplinary rounds the need for a psychiatric referral.

Answer and Explanation

The Correct Answer is C

Choice A reason: Reminding the patient that they will be responsible for caring for the ileostomy after discharge may increase their anxiety and reluctance. It does not address the underlying concerns or feelings.

Choice B reason: Reassuring the patient that the procedure will be reversed in a few months is not always accurate and may provide false hope. Each patient's situation is unique, and not all ileostomies are temporary.

Choice C reason: Acknowledging the patient's reluctance and initiating a discussion to explore their feelings is the most appropriate response. This approach allows the nurse to understand the patient's concerns, provide emotional support, and offer practical solutions to help the patient feel more comfortable with ostomy care.

Choice D reason: Discussing the need for a psychiatric referral during interdisciplinary rounds is not the immediate step. The nurse should first address the patient's feelings and concerns directly and provide support.

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Correct Answer is B

Explanation

Choice A reason: Fruity-smelling breath is a symptom of ketoacidosis, not hypoglycemia. Ketoacidosis occurs when the body produces high levels of ketones due to a lack of insulin, leading to metabolic acidosis.

Choice B reason: Sweating and nervousness are common symptoms of hypoglycemia. Low blood glucose levels trigger the release of adrenaline, which causes these symptoms. Patients should check their blood glucose when experiencing these signs to prevent severe hypoglycemia.

Choice C reason: Nausea and vomiting are more associated with ketoacidosis. High blood glucose levels and the presence of ketones can cause gastrointestinal upset.

Choice D reason: Increased thirst and urination are also symptoms of hyperglycemia and ketoacidosis. These symptoms result from the body's attempt to eliminate excess glucose and ketones through urine.

A. Joint swelling, tenderness, and pain with movement. B. Red ulcers on the buccal mucosa. C. Malar and discoid rashes. D. Dark, foamy urine.

Correct Answer is D

Explanation

Choice A reason: Joint swelling, tenderness, and pain with movement are common symptoms of systemic lupus erythematosus (SLE) but are not immediately life-threatening. They should be managed but are not the priority in this case.

Choice B reason: Red ulcers on the buccal mucosa are a concerning finding in SLE and can indicate active disease, but they are not the priority compared to signs of potential kidney involvement.

Choice C reason: Malar and discoid rashes are typical

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The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care. What is the nurse's most appropriate response to this observation?

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The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care.

What is the nurse's most appropriate response to this observation?