A nurse is educating a patient who has an ileal conduit due to bladder cancer.
Which statement from the patient suggests that further instruction is needed?

Choice A rationale:

Wheezing Wheezing is typically associated with respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD), rather than being a symptom of hyperkalemia.

Choice B rationale:

Cerebral edema Cerebral edema, or swelling in the brain, is not typically a symptom of hyperkalemia. It’s more commonly associated with traumatic brain injury, stroke, or brain tumors.

Choice C rationale:

Decreased deep tendon reflexes Decreased deep tendon reflexes can be a symptom of hyperkalemia. Hyperkalemia is a condition in which the potassium levels in your blood get too high. Potassium helps nerves send signals between your brain and the rest of your body. High levels of potassium can affect nerve function, leading to symptoms such as muscle weakness or decreased reflexes. Choice D rationale:

Hypoactive bowel sounds Hypoactive bowel sounds, or decreased or absent bowel sounds, are typically associated with conditions affecting the gastrointestinal system, such as ileus or bowel obstruction. They are not typically a symptom of hyperkalemia.

Choice A rationale:

The stool guaiac test does not check for bacteria in the feces. This test is used to detect hidden (occult) blood in a stool sample. It is the most common type of fecal occult blood test (FOBT)1.

Choice B rationale:

The stool guaiac test does not check for fat in the feces. The presence of fat in the feces is usually checked by a different test called a fecal fat test. The stool guaiac test is specifically designed to detect the presence of hidden blood in the stool.

Choice C rationale:

The stool guaiac test does not check for parasites in the feces. Parasites are typically detected using a stool ova and parasites (O&P) test. The stool guaiac test is used to detect hidden blood in the stool, which could be an indication of various conditions, including colon cancer or polyps in the colon or rectum.

Choice D rationale:

The stool guaiac test checks for hidden blood in the feces. This is the correct answer. The test can find blood even if you cannot see it yourself. Occult blood in the stool may indicate colon cancer or polyps in the colon or rectum, though not all cancers or polyps bleed. If blood is detected through a fecal occult blood test, additional tests may be needed to determine the source of the bleeding. The stool guaiac test can only detect the presence or absence of blood — it can’t determine what’s causing the bleeding.