What should be considered when deciding placement of a stoma? (Select all that apply.)
Stabilization from the abdominal rectus
Good seal
Proximity to the umbilicus (not too close to area)
Ease of self-care
Inoffensive appearance
Correct Answer : A,B,C,D
Rationale:
A. Stabilization from the abdominal rectus is correct because placing the stoma through the rectus abdominis muscle helps reduce the risk of herniation and provides better support for the stoma.
B. Good seal is correct because proper stoma placement allows the ostomy appliance to adhere securely, reducing leakage and protecting the surrounding skin.
C. Proximity to the umbilicus (not too close to area) is correct because the stoma should not be placed too close to the umbilicus, scars, or skin folds, which can interfere with appliance fit and increase leakage risk.
D. Ease of self-care is correct because the stoma should be located where the client can easily see and reach it, promoting independence in ostomy care.
E. Inoffensive appearance is incorrect because cosmetic appearance is not a priority in determining stoma placement. Function, safety, and the client’s ability to manage the stoma take precedence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. A stoma prolapse occurs when a portion of the intestine protrudes excessively through the stoma site. Increased intra-abdominal pressure from chronic coughing, straining, or heavy lifting can contribute to prolapse, making it a major long-term complication for colostomy patients. It can lead to discomfort, impaired appliance fit, and potential ischemia if severe.
B. While the skin around the stoma can become irritated or inflamed due to poor hygiene, leakage, or allergic reactions, coughing is not a primary cause of long-term inflammation at the stoma site.
C. Obstruction of the stoma usually results from scar tissue, adhesions, or impacted stool, not from coughing. While increased intra-abdominal pressure may transiently affect output, it does not typically cause long-term obstruction.
D. Stenosis (narrowing of the stoma) generally develops from scarring or poor healing, not from repetitive coughing. Coughing primarily contributes to prolapse rather than narrowing.
Correct Answer is D
Explanation
Rationale:
A. Evisceration refers to internal organs protruding through a surgical incision. While serious, it is usually visible at the surgical site and does not explain systemic signs such as fever, tachycardia, and rigid abdomen.
B. Localized inflammation may cause redness, tenderness, or mild discomfort, but it would not typically produce a rigid abdomen, high fever, and elevated pulse and respirations.
C. An obstruction can cause abdominal distention, nausea, vomiting, and decreased stoma output, but a rigid abdomen and systemic signs like fever and tachycardia suggest a more severe intra-abdominal infection.
D. The patient’s rigid abdomen, tachycardia (pulse 120 bpm), tachypnea (respirations 28/min), and fever (101°F) are classic signs of peritonitis, a life-threatening infection of the abdominal cavity. This can occur post-operatively due to leakage from the stoma, bowel perforation, or infection. Prompt recognition and immediate medical intervention are critical, often requiring antibiotics and possible surgical management.
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