A nurse is caring for a client who has a new colostomy and states they are not ready to look at the stoma. Which of the following teaching strategies is helpful and encourages the client to share their feelings about the colostomy?

Question-and-answer

Discussion

Role play

Return demonstration

Answer and Explanation

The Correct Answer is B

Choice A reason: A question-and-answer session might provide information but does not specifically encourage the client to share their feelings and concerns about the colostomy. It's more about imparting knowledge rather than addressing emotional needs.
Choice B reason: Discussion is an effective strategy to encourage the client to share their feelings about the colostomy. It creates an open environment for expressing concerns, asking questions, and receiving emotional support.
Choice C reason: Role play can be useful in teaching new skills or preparing for specific situations, but it might not be the best initial approach for someone struggling to accept a new colostomy. Emotional readiness and comfort should be addressed first.
Choice D reason: Return demonstration is a method to confirm the client's understanding of a procedure by having them perform it. It is more appropriate for assessing practical skills rather than addressing emotional concerns and readiness to engage with the stoma.

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Correct Answer is A

Explanation

Choice A reason: Mr. Smith requires immediate attention due to his multiple sclerosis and severe symptoms of chills, fatigue, and a high fever (103°F). These symptoms could indicate a severe infection such as a urinary tract infection (UTI) or even sepsis, which can be life-threatening, especially in individuals with a compromised immune system or chronic conditions like multiple sclerosis.
Choice B reason: Ms. Jones's dry mouth is a common side effect of Ditropan (oxybutynin), which is used to treat urinary frequency and urgency. While it is uncomfortable, it is not an emergency and can be addressed at the next visit or over a phone consultation.
Choice C reason: Mr. Jones, being a new patient with incontinence concerns, does not present an immediate emergency. This issue, while significant for his quality of life, can be managed through a scheduled appointment.
Choice D reason: Ms. Smith's decision to cancel her appointment due to her symptoms not being severe does not require immediate attention. She can be rescheduled for a later date without risk to her health.

A. Impaired skin integrity B. Disturbed body image C. Fluid volume deficit D. Anxiety E. Infection

Correct Answer is A

Explanation

Choice A reason: Impaired skin integrity is a significant risk due to the constant exposure of the skin around the stoma to urine, which can lead to irritation and breakdown. Proper skin care and stoma care are essential to prevent complications.
Choice B reason: Disturbed body image is also a risk as the client adjusts to the physical changes and the presence of a stoma, which can impact self-esteem and body perception.
Choice C reason: Fluid volume deficit can occur if the client does not maintain adequate fluid intake or if there is significant leakage from the stoma. Monitoring fluid balance is crucial.
Choice D reason: Anxiety is common as clients adapt to managing a new ostomy, worrying about potential complications, and coping with changes in body function.
Choice E reason: Infection is a risk due to the exposure of the stoma and surrounding skin to bacteria from the urine. Proper hygiene and care are vital to prevent infections.

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A nurse is caring for a client who has a new colostomy and states they are not ready to look at the stoma. Which of the following teaching strategies is helpful and encourages the client to share their feelings about the colostomy?

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