You're advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Yogurt. Yogurt is a good choice for individuals with a colostomy experiencing flatus issues because it contains probiotics that can help regulate the digestive system and reduce gas production. Probiotics promote a healthy balance of gut bacteria, which can improve digestion and decrease bloating and gas. Option A) Peas, Option B) Cabbage, and Option C) Broccoli are high-fiber foods that can increase gas production in individuals with a colostomy. These foods are known to produce more gas during digestion, leading to increased flatulence. Therefore, recommending these options to someone experiencing flatus issues may exacerbate their symptoms rather than alleviate them. From an educational perspective, it is essential for healthcare providers, especially those working with patients with colostomies, to have a good understanding of dietary recommendations that can help manage common issues such as flatus. Encouraging the consumption of yogurt with probiotics not only helps address the immediate concern of excessive gas but also promotes overall digestive health for individuals with colostomies. This knowledge empowers healthcare professionals to provide holistic care that considers both the medical condition and dietary factors impacting the patient's well-being.

Correct Answer: B

Rationale: In medical-surgical nursing, the correct order for performing an abdominal assessment is observation, auscultation, percussion, and palpation. This order is crucial for a comprehensive assessment of the gastrointestinal system. Observation allows the nurse to visually assess any abnormalities such as distention or scars. Auscultation comes next to listen for bowel sounds, followed by percussion to assess the presence of gas or fluid in the abdomen. Palpation, the final step, helps to identify tenderness, masses, or organ enlargement. Option A is incorrect because percussion should precede palpation in an abdominal assessment. Option C is incorrect as palpation should come before auscultation. Option D is incorrect because observation should be the first step in the assessment. Educationally, understanding the correct sequence of an abdominal assessment is essential for nurses to accurately identify potential issues and provide appropriate care to their patients. Following the correct order ensures a systematic approach that enhances assessment accuracy and patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: The surgery occurs in two stages. The rationale behind this is that creating an ileoanal reservoir involves a two-stage surgical procedure. In the first stage, the colon is removed, and the ileoanal reservoir is created, allowing for the storage of stool. A temporary ileostomy may be created to allow healing. In the second stage, the ileostomy is closed, and the patient is then able to pass stool through the newly created reservoir. Option A: A reservoir is created that exits through the abdominal wall is incorrect because the ileoanal reservoir is typically internal and does not exit through the abdominal wall. Option B: A second surgery is required 12 months after the first surgery is incorrect because the two-stage surgery typically occurs within a few months of each other, not 12 months apart. Option C: A permanent ileostomy is created is incorrect because the goal of the ileoanal reservoir surgery is to avoid the need for a permanent ileostomy by creating a new storage area for stool. Educationally, understanding the two-stage process of creating an ileoanal reservoir is crucial for nurses caring for patients with ulcerative colitis undergoing this surgery. This knowledge allows nurses to provide accurate preoperative teaching, prepare patients for what to expect during the surgical process, and support them through their recovery journey.

Correct Answer: B

Rationale: In the context of caring for a client hospitalized for an exacerbation of ulcerative colitis, the priority goal during the first days would be managing diarrhea, making option B the correct answer. This is because diarrhea is a common symptom of ulcerative colitis exacerbation and can lead to dehydration, electrolyte imbalances, and worsening of the condition. By effectively managing diarrhea, the healthcare team can help stabilize the client's condition and prevent further complications. Promoting self-care and independence (option A) is important in the long term but may not be the immediate priority during the acute phase of exacerbation when the client may require more intensive nursing care. Maintaining adequate nutrition (option C) is crucial in managing ulcerative colitis, but addressing diarrhea takes precedence in the initial phase. Promoting rest and comfort (option D) is also important but may not directly address the urgent physiological needs associated with diarrhea management. In an educational context, understanding the prioritization of care goals in different phases of a client's condition is essential for nurses. By recognizing the most critical needs of the client at any given time, nurses can provide effective and timely care to improve patient outcomes and prevent complications. This case highlights the significance of clinical judgment and critical thinking in nursing practice.

Correct Answer: C

Rationale: In this scenario where a client with ulcerative colitis has symptoms for over a week, the nurse should carefully assess for signs of hypokalemia, making option C the correct choice. Ulcerative colitis can lead to electrolyte imbalances due to chronic inflammation and diarrhea, resulting in potassium loss. Hypokalemia can lead to serious complications like cardiac dysrhythmias and muscle weakness. Option A, heart failure, is not directly associated with ulcerative colitis unless there are underlying cardiovascular conditions. Option B, DVT (deep vein thrombosis), is more commonly associated with immobility and hypercoagulability rather than ulcerative colitis. Option D, hypocalcemia, is less likely in this context as it is not a common complication of ulcerative colitis compared to electrolyte imbalances like hypokalemia. Educationally, understanding the complications of ulcerative colitis is crucial for nurses to provide comprehensive care and early intervention. Recognizing the signs and symptoms of hypokalemia in this case can prevent serious adverse outcomes for the client. Integrating pathophysiology knowledge with clinical assessment skills is essential in medical-surgical nursing practice.