A nurse is providing discharge teaching to a client who has an ileostomy. Which of the following client statements indicates an understanding of the teaching?
"I will empty my bag when it is full."
"I will take a laxative when I'm constipated."
"I will expect my stools to be loose."
"I will eat a high-fiber diet."
The Correct Answer is C
An ileostomy is a surgical opening in the abdomen that connects the end of the small intestine (ileum) to a pouch or bag on the outside of the body. The ileostomy bypasses the large intestine (colon) and rectum, which normally absorb water and form solid stools. Therefore, the client should expect their stools to be loose and watery. The client should empty their bag several times a day, not when it is full, to prevent leakage and skin irritation. The client should avoid laxatives, which can cause dehydration and electrolyte imbalance. The client should also avoid high-fiber foods, which can cause blockage or irritation of the ileostomy.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Allow the client to sign the consent with an X. The client has the right to give informed consent if they understand the procedure and its risks and benefits, even if they cannot read or write. The nurse should witness and document the client's signature with an X and verify their identity and understanding. The other options are not appropriate because they violate the client's autonomy and dignity.
Correct Answer is A
Explanation
The client who has an allergy to bananas may also have an allergy to latex, as they share some common proteins that can trigger an immune response. The nurse should avoid using latex gloves, catheters, syringes, or other products that may contain latex when caring for this client. The other options are not related to banana allergy.
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