A nurse is planning care for a client who reports having difficulty sleeping. Which of the following interventions should the nurse include in the plan of care?

Choice A rationale:

Apply the skin sealant on damp skin. Rationale: Applying skin sealant on damp skin is not the recommended approach for securing an ostomy appliance. It's important to ensure that the skin is clean and dry before applying the sealant or the skin barrier. Moisture can compromise adhesion and lead to skin irritation or appliance detachment.

Choice B rationale:

Remove the appliance before emptying the pouch. Rationale: Removing the appliance before emptying the pouch is not a necessary step when changing an ostomy appliance. Typically, the pouch can be emptied without removing the entire appliance, which helps maintain the seal and reduces unnecessary skin exposure.

Choice C rationale:

Ensure that the skin is slightly damp for better adhesion of the pouch. Rationale: Ensuring that the skin is slightly damp is not advisable for better adhesion of the pouch. The skin should be completely dry before applying the pouch to ensure proper adhesion. Moisture on the skin can lead to leakage or detachment of the appliance.

Choice D rationale:

Trace the size of stoma onto the skin barrier. Rationale: This choice is the correct answer because tracing the size of the stoma onto the skin barrier ensures a precise fit, which is crucial for preventing leaks and maintaining the integrity of the ostomy. A proper fit also helps in preventing skin irritation and discomfort. Choosing the correct barrier size based on the stoma's dimensions is a key aspect of effective ostomy care.

Choice A rationale:

Before initiating teaching for a client with a new diagnosis of type 2 diabetes mellitus, it is essential to identify the client's learning needs. This involves assessing what the client already knows about the condition, their level of understanding, and any specific areas of concern or interest. By establishing the learning needs, the nurse can tailor the teaching plan to address the client's individual requirements, thereby enhancing the effectiveness of the education provided.

Choice B rationale:

While determining the client's literacy level (Choice B) is important, it might not take precedence over understanding the client's learning needs. However, assessing literacy is still relevant because it helps the nurse adapt the teaching materials and language used to ensure the client comprehends the information.

Choice C rationale:

Evaluating the client's readiness for learning (Choice C) is significant, but it should ideally follow the identification of learning needs. Readiness for learning pertains to the client's emotional and psychological state, which can impact their ability to absorb new information. While essential, it should not be the initial step in planning teaching.

Choice D rationale:

Verifying the client's computer access (Choice D) is not directly related to the immediate planning of teaching for a new diagnosis of type 2 diabetes mellitus. While technology and access to online resources can enhance learning, this consideration is secondary to understanding the client's knowledge gaps and preferred learning style.

Choice E rationale:

Identifying the client's learning style (Choice E) is valuable in customizing the teaching approach, but it comes after establishing learning needs. Learning styles, such as visual, auditory, or kinesthetic, can influence the most effective way to present information. However, without first determining what the client needs to know, tailoring the teaching style might not yield optimal results.