The nurse is completing discharge teaching with a patient following an ileostomy. Which statement by the patient indicates the need for more teaching concerning the ileostomy?

"I can still participate in physical activities and exercise with an ileostomy."

"I should empty the pouch when it is about two-thirds full."

"I should apply adhesive remover to the skin around the stoma when changing the pouch."

"I can eat all my favorite foods now that I have an ileostomy."

Answer and Explanation

The Correct Answer is D

A. This is an appropriate statement. Most patients with an ileostomy can resume physical activities and exercise, though they should be mindful of their stoma and pouch during activities.
B. This is a correct statement. The pouch should be emptied when it is about one-third to one-half full to prevent it from becoming too heavy or causing skin irritation.
C. This is also correct. Adhesive remover can be used to gently remove the pouch and adhesive, preventing irritation to the skin around the stoma.
D. This statement indicates a need for more teaching. While many foods can be eaten after an ileostomy, some foods may cause blockages or discomfort (e.g., nuts, seeds, and high-fiber vegetables). Patients need to be educated on dietary modifications and precautions post-ileostomy.

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Correct Answer is ["A","B","D"]

Explanation

A. Maintaining a healthy weight is important in managing a hiatal hernia. Excess weight can increase abdominal pressure, which may worsen symptoms of acid reflux.
B. Sleeping with the head of the bed elevated helps prevent acid reflux and symptoms of heartburn associated with a hiatal hernia. Elevation reduces the risk of stomach contents moving into the esophagus during sleep.
C. Drinking less fluid is not a necessary dietary change for hiatal hernia management. However, clients should avoid consuming large amounts of fluid with meals, as this may exacerbate reflux symptoms.
D. Consuming less caffeine and fewer spicy foods is appropriate because both can irritate the esophagus and increase acid reflux. Caffeine and spicy foods are known to trigger symptoms in individuals with a hiatal hernia.
E. Lying down for one-half hour after meals is not recommended for clients with a hiatal hernia, as it can worsen symptoms of reflux. The client should be advised to wait at least 2–3 hours before lying down after eating.

A. Review the client's electrolyte values. B. Obtain a dietary history from the client. C. Check the client's perianal skin integrity. D. Investigate the client's emotional concerns.

Correct Answer is A

Explanation

A. Reviewing electrolyte values is the first action to take, as clients with acute exacerbations of ulcerative colitis are at risk for electrolyte imbalances due to diarrhea and fluid loss. It is essential to correct any imbalances promptly to avoid complications like cardiac arrhythmias.
B. While obtaining a dietary history is important to understand the client's eating habits and trigger foods, it is not the priority when the client is experiencing an acute exacerbation. Addressing immediate physiological needs comes first.
C. Checking perianal skin integrity is important, as diarrhea and frequent bowel movements can lead to irritation or breakdown of the skin, but this is not the first priority in the acute phase of exacerbation. Managing electrolyte levels and hydration takes precedence.
D. Investigating emotional concerns is important in the holistic care of the patient, but it is not the first priority in managing an acute exacerbation of ulcerative colitis. Ensuring the client is physically stable through electrolyte management is more urgent.

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The nurse is completing discharge teaching with a patient following an ileostomy. Which statement by the patient indicates the need for more teaching concerning the ileostomy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is caring for a client who is being admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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