A nurse is caring for a client who has a newly created colostomy. The client's partner tells the nurse that the client refuses to look at the stoma. Which of the following actions should the nurse take?

Encourage the client and partner to avoid expressing negative feelings about the colostomy.

Suggest the client join a support group for people who have colostomies.

Instruct the client's partner to assume care of the colostomy for the client.

Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Encourage the client and partner to avoid expressing negative feelings about the colostomy: Suppressing negative emotions can hinder psychological adjustment. Clients should be encouraged to express their feelings openly as part of the adaptation and coping process.

B. Suggest the client join a support group for people who have colostomies: Support groups can provide emotional reassurance, shared experiences, and practical coping strategies. Seeing others manage their stomas successfully can promote acceptance and self-confidence.

C. Instruct the client's partner to assume care of the colostomy for the client: While partner support is important, encouraging dependence may delay the client’s adjustment and self-care ability. The goal should be to promote independence and acceptance at the client’s pace.

D. Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy: A transfer is not necessary unless the client has complex needs. Initial support, education, and emotional guidance should be provided in the current care setting.

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Correct Answer is A

Explanation

Rationale:

A. Frequent swallowing: Frequent swallowing, especially of small amounts, can indicate that the child is swallowing blood from postoperative bleeding. This is a common early sign of hemorrhage following a tonsillectomy and requires immediate evaluation.

B. Increased drowsiness: Drowsiness can result from anesthesia, pain medication, or fatigue after surgery. While it should be monitored, it is not a specific indicator of postoperative hemorrhage in a child following tonsillectomy.

C. Elevated pain level: Pain is expected after tonsillectomy and does not necessarily signal bleeding. Sudden severe pain might warrant reassessment, but elevated pain alone is not a definitive sign of hemorrhage.

D. Diminished breath sounds: Diminished breath sounds are not typically associated with post-tonsillectomy hemorrhage. This finding may indicate a respiratory issue, but not specifically bleeding from the surgical site.

A. "Every so often, I think about whether or not to have this surgery." B. "I will talk with the doctor about my surgery when I get into the operating room." C. "Can you tell me more about the surgery I am having?" D. "Signing this form indicates that I give my permission for the surgery, right?"

Correct Answer is D

Explanation

Rationale:

A. "Every so often, I think about whether or not to have this surgery.": This statement suggests the client is still ambivalent or uncertain, which means informed consent has not yet been fully achieved. Clients must be sure and fully informed before agreeing to proceed.

B. "I will talk with the doctor about my surgery when I get into the operating room.": Informed consent must be obtained well before the procedure begins. Waiting until the operating room is inappropriate, as the client may be under stress or sedation.

C. "Can you tell me more about the surgery I am having?": This indicates the client lacks essential information about the procedure. Informed consent requires that the client already understand the nature, risks, benefits, and alternatives before signing.

D. "Signing this form indicates that I give my permission for the surgery, right?": This reflects an understanding that the consent form gives legal authorization for the procedure. It shows the client knows their signature confirms informed agreement to the surgery.

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A nurse is caring for a client who has a newly created colostomy. The client's partner tells the nurse that the client refuses to look at the stoma. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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