ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 48 : Caring for Clients With Ostomies Questions
Question 1 of 5
The nurse is discussing care of the client's ileostomy and is instructing the client to avoid certain medications that move through without being absorbed. What medications should the client avoid? Select all that apply.
Correct Answer: A,C,D
Rationale: Clients with an ileostomy should avoid enteric-coated products and some modified-release drugs, such as slow-release beads and layered tablets. These products may pass through without being absorbed. The client may take liquid and chewable tablets because they will go through the breakdown process in the stomach.
Question 2 of 5
A male client will be having an ileoanal anastomosis for the treatment of chronic ulcerative colitis. What is the benefit to this client of having this procedure rather than a total colectomy? Select all that apply.
Correct Answer: A,B,C,D
Rationale: The ileoanal reservoir, also called an ileoanal anastomosis, is a procedure that maintains bowel continence. It is performed on selected clients who have chronic ulcerative colitis or whose disease does not affect the anorectal sphincter. Besides allowing the client to control bowel elimination, this procedure, as opposed to a conventional ileostomy with total colectomy, preserves innervation to the male genitalia. Subsequently, the male client is unlikely to experience bladder dysfunction, erectile dysfunction, or infertility. The client will not be able to have this surgery done on an outpatient basis, they require postoperative care for a longer duration.
Question 3 of 5
A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. The nurse would monitor this client for which of the following?
Correct Answer: D
Rationale: Adrenal crisis is potentially life-threatening and may result from the abrupt withdrawal of corticosteroids.
Therefore, the nurse should closely monitor a client who is scheduled for an ileostomy surgery for adrenal insufficiency, resulting from corticosteroid withdrawal. Withdrawal of corticosteroids does not cause cerebral anoxia, cardiac dysrhythmias, or hypothyroidism.
Question 4 of 5
Which intervention would be most appropriate for a client who has undergone colostomy surgery?
Correct Answer: C
Rationale: The nurse should monitor the volume of suctioned gastric secretions in a client who has undergone colostomy surgery. The nurse should monitor vital signs once every 4 hours and take temperature by any route other than rectal. The nurse should also ensure that the client's fluid intake is adequate and not minimized.
Question 5 of 5
A nurse is preparing to administer the prescribed vitamin B12 to a client who has had most of his ileum removed. The nurse understands that this is necessary for which reason?
Correct Answer: B
Rationale: Parenteral injections or intranasal administrations of vitamin B12 are used to prevent deficiencies in clients who have had most or all of the ileum removed because this area is responsible for B12 absorption. Vitamin B12 does not prevent thrombosis or constipation or aid digestion.