A teaching plan developed by the nurse for the patient with a new ileal conduit includes instructions to do what?

Correct Answer: C

Rationale: The correct answer is C because using sterile supplies and technique during care of the stoma is crucial to prevent infection and promote healing. Cleanliness is essential in stoma care to avoid complications. Using a wick or changing the appliance every day may not be the most important aspect of caring for a new ileal conduit.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Failure to take thyroid medication. Myxedema coma is a life-threatening complication of untreated or undertreated hypothyroidism, where severely low thyroid hormone levels lead to decreased metabolism and a cascade of physiological effects, such as hypothermia, altered mental status, and organ failure. Mrs. T's condition likely deteriorated due to a lack of thyroid hormone replacement therapy, leading to the development of myxedema coma. Option A) Hypothermia is a symptom of myxedema coma, not the cause. It results from the body's decreased ability to regulate temperature due to low thyroid hormone levels. Option C) Overdose of thyroid medication would typically lead to symptoms of hyperthyroidism, such as tachycardia, weight loss, and anxiety, rather than myxedema coma. Option D) Failure to follow a prescribed diet may impact overall health but would not directly lead to myxedema coma in the context of hypothyroidism. Educationally, this question highlights the critical importance of medication adherence in managing chronic conditions like hypothyroidism. It emphasizes the severe consequences that can arise from neglecting prescribed treatments and the need for patients to understand the significance of following medical recommendations to prevent life-threatening complications. By understanding this case, healthcare providers and patients can work together to ensure optimal management of chronic diseases and prevent avoidable emergencies.

Correct Answer: A

Rationale: Water intoxication, also known as water poisoning or dilutional hyponatremia, occurs when there is an imbalance of water and electrolytes in the body, leading to low sodium levels in the blood. The correct answer is A) Confusion and restlessness. These symptoms are indicative of water intoxication as the decrease in sodium levels can affect brain function, leading to neurological symptoms like confusion and restlessness. Option B) Increased serum sodium concentration is actually a sign of dehydration or hypernatremia, not water intoxication. In water intoxication, there is a dilution of sodium in the blood leading to hyponatremia. Option C) Cool, clammy skin is a nonspecific symptom and is not typically associated with water intoxication. It is more commonly seen in conditions like shock or low blood sugar. Option D) Marked peripheral edema is a sign of fluid overload rather than water intoxication. It can be seen in conditions like heart failure or kidney disease where the body retains excess fluid leading to swelling in the extremities. In an educational context, understanding the symptoms of water intoxication is crucial for healthcare professionals, especially those involved in post-operative care where excessive bladder irrigation solutions may be used. Recognizing the early signs of water intoxication can prompt timely intervention to prevent serious complications such as seizures, coma, or even death. Educating healthcare providers on the importance of monitoring electrolyte imbalances and being vigilant for subtle changes in a patient's condition can significantly impact patient outcomes.

Correct Answer: B

Rationale: When assisting urosto-mates with a pouch change, it is important to cut the pouch opening approximately 3 mm larger than the stoma to prevent irritation and ensure a proper fit. This allows for a better seal and reduces the risk of leakage or skin damage. Scrubbing the peristomal skin with a deodorant soap, drying the skin with alcohol wipes, or placing aspirin in the pouch are not recommended practices and may lead to complications.