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Which is a major long-term complication caused by coughing in a patient with a colostomy?

A.

prolapse

B.

inflammation

C.

obstruction

D.

stenosis

Answer and Explanation

The Correct Answer is A

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.


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Related Questions

Correct Answer is A

Explanation

Rationale:

A. The paste under a colostomy or ileostomy appliance creates a seal between the stoma and the wafer, preventing leakage of effluent onto the skin. Simply taping the wafer may not provide an adequate seal, increasing the risk of leakage, skin irritation, and infection. This response educates the patient on the functional importance of the paste.

B. This response is vague and non-informative, and does not explain why the paste is necessary or the risks of not using it. It fails to address the patient’s concern.

C. This is incorrect. Waterproof tape alone does not conform to the stoma or fill uneven skin surfaces, so it cannot replace the sealant paste, increasing the likelihood of leakage and skin breakdown.

D. While tape can irritate the skin, the main concern is seal integrity and prevention of leakage, not just skin irritation. This explanation does not fully address the functional reason for using paste.

Correct Answer is B

Explanation

Rationale:

A. Having another type of cancer is not a recognized risk factor for developing chronic myelogenous leukemia (CML). While some treatments for other cancers (like chemotherapy or radiation) may slightly increase leukemia risk, simply having another cancer is not a direct risk factor.

B. Exposure to high levels of ionizing radiation is a known risk factor for CML. Historical data from atomic bomb survivors and certain radiation accidents demonstrate increased incidence of CML in those exposed to significant radiation. This is considered one of the primary environmental risk factors for the disease.

C. While CML is associated with the Philadelphia chromosome (a genetic abnormality), this is a somatic mutation acquired during life in hematopoietic stem cells, not an inherited genetic mutation. Therefore, inherited genetic mutations are not a recognized predisposing factor.

D. CML is generally not considered hereditary, and having a family history of CML does not significantly increase risk. Most cases occur sporadically due to acquired mutations in the bone marrow.

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