A nurse in a provider's office is collecting data from a client who is 1 month postoperative following an ileostomy. Which of the following statements by the client indicates the client is in the acceptance stage of grieving?

"I have purchased a stoma cap I can use when needed."

"I have my partner empty my pouch for me every morning."

"I am embarrassed by the odor that comes from my ileostomy."

"I miss going to my church meetings because of this ostomy."

Answer and Explanation

The Correct Answer is A

Choice A reason: Purchasing a stoma cap that can cover and conceal the ileostomy when not in use indicates that the client is in the acceptance stage of grieving, as it shows that they have adapted to their new condition and are able to resume their normal activities and social interactions.

Choice B reason: Having their partner empty their pouch for them every morning indicates that the client is in the denial stage of grieving, as it shows that they are avoiding or rejecting their new condition and are dependent on others for their care.

Choice C reason: Being embarrassed by the odor that comes from their ileostomy indicates that the client is in the depression stage of grieving, as it shows that they have low self-esteem and negative feelings about their new condition and its impact on their quality of life.

Choice D reason: Missing going to their church meetings because of their ostomy indicates that the client is in the anger stage of grieving, as it shows that they have resentment and frustration about their new condition and its interference with their previous routines and values.

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Correct Answer is A

Explanation

Choice A reason: Urinating before and after sexual intercourse can help flush out any bacteria that may have entered the urinary tract during sexual activity, and prevent them from causing an infection.

Choice B reason: Increasing milk consumption to make the urine more alkaline is not a recommended instruction, as it may increase the risk of developing kidney stones or calcium deposits in the urinary tract.

Choice C reason: Emptying the bladder at least every 4 hours is a good practice, but not sufficient to prevent urinary tract infections. The nurse should also advise the client to drink plenty of fluids, especially water, to dilute the urine and flush out bacteria.

Choice D reason: Using vaginal douche once a week is not a recommended instruction, as it may alter the normal flora of the vagina and increase the risk of infection. The nurse should advise the client to avoid using any products that may irritate the genital area, such as perfumed soaps, sprays, or powders.

Choice E reason: Drinking cranberry juice daily is not a proven method to prevent urinary tract infections, although some studies suggest that it may have some benefits. The nurse should inform the client that cranberry juice may interact with some medications, such as warfarin, and that it may also increase the acidity of the urine, which can cause discomfort or burning sensation.

A. You should shower instead of taking a tub bath. B. You may take aspirin for mild pain. C. You should avoid lifting objects that weigh more than 8 pounds. D. You might see blood in your urine after coughing. E. You may resume sexual intercourse after 2 weeks.

Correct Answer is ["A","C","D"]

Explanation

a) You should shower instead of taking a tub bath. This is correct because showering reduces the risk of infection and promotes wound healing.

b) You may take aspirin for mild pain. This is incorrect because aspirin can increase the risk of bleeding and interfere with clotting. The client should take acetaminophen or another nonsteroidal anti-inflammatory drug (NSAID) for pain relief.

c) You should avoid lifting objects that weigh more than 8 pounds. This is correct because lifting heavy objects can strain the surgical site and cause bleeding or herniation.

d) You might see blood in your urine after coughing. This is correct because coughing can increase the pressure in the bladder and cause blood to leak from the urethra. This is normal and should subside within a few days.

e) You may resume sexual intercourse after 2 weeks. This is incorrect because sexual intercourse can cause trauma to the prostate and urethra and delay healing. The client should wait at least 6 weeks before resuming sexual activity.

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A nurse in a provider's office is collecting data from a client who is 1 month postoperative following an ileostomy. Which of the following statements by the client indicates the client is in the acceptance stage of grieving?

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