What health instruction will enhance regulation of a colostomy (defecation) of clients?

Correct Answer: A

Rationale: The correct answer is A) Irrigate after lunch everyday. This health instruction enhances regulation of a colostomy for clients because irrigation helps to establish a regular bowel routine, promoting more predictable bowel movements and helping to prevent constipation or diarrhea. By irrigating after lunch every day, clients can establish a consistent schedule for bowel elimination, which can improve their quality of life and prevent complications related to their colostomy. Option B) Eat fruits and vegetables in all three meals is incorrect because while a balanced diet is important for overall health, it may not specifically enhance regulation of a colostomy. Consuming fruits and vegetables is beneficial for general health but does not directly impact colostomy regulation. Option C) Eat balanced meals at regular intervals is a good general health recommendation, but it does not address the specific needs of clients with a colostomy. While maintaining a balanced diet is important, it alone may not be sufficient to regulate bowel movements in clients with a colostomy. Option D) Restrict exercise to walking only is incorrect because regular exercise, including a variety of activities beyond just walking, is important for overall health and can actually help with colostomy regulation by promoting bowel motility. Restricting exercise to only walking may limit the potential benefits of physical activity for clients with a colostomy. In an educational context, it is important for healthcare providers to understand the specific needs of clients with a colostomy and provide tailored health instructions to help them manage their condition effectively. By educating clients on the benefits of irrigation after lunch every day, healthcare providers can empower clients to take control of their bowel routine and improve their quality of life.

Correct Answer: C

Rationale: In the context of colostomy irrigation, the correct answer is C because discontinuing the insertion of fluid after only 500 ml has been instilled is incorrect. A typical colostomy irrigation involves instilling 500-1000 ml of fluid to effectively cleanse the colon. By stopping at 500 ml, the irrigation process may be incomplete, leading to ineffective colonic cleansing and potential complications like constipation or impaction. Option A is correct as lubricating the tip of the catheter prior to insertion helps reduce friction, making the process more comfortable and reducing the risk of injury to the stoma. Option B is incorrect as hanging the irrigating bag on the bathroom door cloth hook during fluid insertion is a common practice that allows for easy access and manipulation of the bag during the procedure. Option D is incorrect because clamping off the flow of fluid when feeling uncomfortable is a safety measure that allows the patient to control the flow rate and stop the procedure if they experience discomfort or pain. Educationally, understanding the correct volume of fluid needed for colostomy irrigation is crucial to ensure effective cleansing and prevent complications. It is important for healthcare providers to educate patients on the proper technique and indications for colostomy irrigation to promote optimal outcomes and patient comfort.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) to decongest. The rationale behind this is that after a thoracentesis, where fluid is removed from the pleural space, a chest x-ray may be ordered to assess the re-expansion of the lung and to ensure that there is no fluid accumulation or complications. This helps in monitoring the effectiveness of the procedure and the overall lung health. Option A) to rule out pneumothorax is incorrect because a chest x-ray is typically not needed to diagnose a pneumothorax immediately after a thoracentesis, as this complication would be evident during the procedure itself. Option B) to rule out any possible perforation is incorrect because perforation would typically be suspected during the thoracentesis procedure itself, and immediate intervention would be taken if this were the case. Option D) to rule out any foreign body is incorrect as well because a chest x-ray would not be the primary diagnostic tool for detecting a foreign body in this context; other imaging modalities or procedures would be more appropriate for this purpose. Educationally, understanding the rationale behind post-thoracentesis care and monitoring is crucial for nurses and healthcare providers involved in the management of patients undergoing such procedures. It reinforces the importance of appropriate diagnostic tests and monitoring to ensure patient safety and optimal outcomes.

Correct Answer: C

Rationale: In the context of pharmacology and the study of infectious diseases, understanding the causative agents of specific infections is crucial for effective treatment and prevention strategies. In the case of Pyelonephritis in hospitalized patients with prolonged catheterization, the most common causative agent is Proteus mirabilis. The correct answer, Option C, is Proteus mirabilis. This bacterium is known to ascend through the urinary tract, colonize the bladder, and subsequently infect the kidneys, causing Pyelonephritis. Its ability to form urease enzymes contributes to its pathogenicity in catheterized patients. Option A, E. coli, is a common cause of urinary tract infections but is not specifically associated with Pyelonephritis in catheterized patients. Option B, Klebsiella, is more commonly linked to pneumonia and other respiratory infections. Option D, Staphylococcus, is a common cause of skin and soft tissue infections but is not a typical causative agent of Pyelonephritis in catheterized patients. Educationally, understanding the specific pathogens associated with different infections is crucial for pharmacology students and healthcare professionals when selecting appropriate antimicrobial therapies and implementing infection control measures. By knowing the typical causative agents of Pyelonephritis in specific patient populations, such as those with prolonged catheterization, clinicians can tailor treatment regimens to target the most likely pathogens, improving patient outcomes and reducing the development of antimicrobial resistance.

Correct Answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.