A nurse is performing discharge teaching with a client about the care of a newly created ileal conduit. The nurse should instruct the client to empty the appliance:
Daily at bedtime.
Twice a day.
When the bag is full.
When the bag is 2/3 full.
The Correct Answer is D
Choice A reason: Emptying the appliance daily at bedtime is not frequent enough to prevent leakage and ensure comfort, especially if the bag fills up during the day or night.
Choice B reason: Emptying the appliance twice a day may not be sufficient, depending on the amount of urine output. It could lead to overfilling and leakage.
Choice C reason: Waiting until the bag is full can increase the risk of leakage and discomfort. It is essential to empty the bag before it gets too full.
Choice D reason: Emptying the appliance when it is 2/3 full is the recommended practice. This prevents overfilling, reduces the risk of leakage, and ensures the client's comfort and hygiene.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Monitoring bowel sounds is important for assessing gastrointestinal function, but it does not directly measure the effectiveness of lactulose in treating hepatic encephalopathy.
Choice B reason: Temperature monitoring is essential for detecting infection, but it does not indicate the effectiveness of lactulose in reducing ammonia levels.
Choice C reason: Abdominal pain should be monitored as a potential side effect of lactulose, but it is not an indicator of its effectiveness in treating hepatic encephalopathy.
Choice D reason: Stool frequency is the correct measure for monitoring the effectiveness of lactulose. Lactulose works by promoting the excretion of ammonia in the stool, thereby reducing serum ammonia levels and improving the symptoms of hepatic encephalopathy. Increased stool frequency indicates the medication is working.
Correct Answer is C
Explanation
Choice A reason: Urine in the drainage appliance is an expected finding since the ileal conduit diverts urine through the stoma.
Choice B reason: Redness of the stoma is a normal finding postoperatively as the tissue heals.
Choice C reason: Feces in the drainage appliance is unexpected and indicates a possible fistula or leakage from the intestine into the urinary tract.
Choice D reason: Edema of the stoma is common postoperatively due to surgical trauma and is typically temporary.
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