A nurse is assisting with the care of a client who is receiving an IV infusion of dextrose 10% in water. The nurse should monitor the client for which of the following adverse effects?

Choice A reason: Memory loss is not typically associated with vitamin C deficiency. Memory loss can be related to various conditions, including neurological disorders or vitamin B12 deficiency.

Choice B reason: Brittle hair can be a sign of vitamin C deficiency due to its role in collagen production, which affects the health of hair. However, it is not as specific or common as bleeding gums.

Choice C reason: Bleeding gums are a common symptom of vitamin C deficiency. Vitamin C is essential for the maintenance of healthy connective tissue, which includes the gums. A deficiency can lead to scurvy, which manifests as bleeding gums among other symptoms.

Choice D reason: Constipation is not directly associated with vitamin C deficiency. While a healthy diet rich in vitamin C can aid digestion, constipation can be caused by a variety of factors unrelated to vitamin C intake.

Answer: B

Rationale:

A. "You should expect your stoma to be a purple color": A healthy stoma should be pink or red in color. A purple or dark-colored stoma may indicate poor blood flow and could be a sign of complications requiring immediate medical attention.

B. "You will have a stoma in your left lower abdomen": For a sigmoid colostomy, the stoma is typically located in the left lower quadrant of the abdomen. This placement is consistent with the nature of the procedure and is a correct and important piece of information for preoperative teaching.

C. "Your colostomy will not produce formed stool": A sigmoid colostomy usually results in the production of more formed stool because it is located closer to the rectum, where most of the water has been absorbed. Expecting unformed stool is more typical of a colostomy in the ascending or transverse colon.

D. "The end of the stoma will be painful after this procedure": While some discomfort is normal postoperatively, the stoma itself should not be persistently painful. Pain management and proper care should be addressed, but ongoing severe pain could indicate complications.