A nurse is providing teaching for a client who has diabetes and a new prescription for Insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin?

A. Clean the peristomal skin four times a day:
While keeping the peristomal skin clean is essential, cleaning it four times a day might be excessive and could lead to skin irritation. Typically, cleansing the area when changing the pouch or as needed is sufficient.

B. Hold pressure on the skin barrier for 10 to 15 seconds to secure the seal:
Applying gentle pressure upon application can assist in securing the seal, but the duration might vary based on the manufacturer's recommendations. It's important not to overly press or manipulate the barrier excessively, as it could cause skin trauma.

C. Empty the pouch when it is 1/3 full:
This is the correct advice. Regularly emptying the pouch prevents leakage and ensures the pouch does not become too heavy or cause skin irritation from weight or pressure.

D. Expect firm fecal content:
With an ileostomy, the fecal content tends to be more liquid compared to other types of ostomies like colostomies, so expecting firm fecal content might not be accurate for this situation.

A. Fatty stools:

Obstruction of the common bile duct can result in impaired bile flow, leading to a decrease in bile salts reaching the intestine. This can result in the malabsorption of fats, causing fatty or greasy stools (steatorrhea).

B. Tenderness in the left upper abdomen:

Tenderness in the left upper abdomen might be more commonly associated with conditions like splenic issues or stomach problems rather than an obstruction of the common bile duct.

C. Straw-colored urine:

Straw-colored urine is typical of well-hydrated individuals and might not directly correlate with an obstruction of the common bile duct.

D. Ecchymosis of the extremities:

Ecchymosis (bruising) of the extremities is not typically associated with an obstruction of the common bile duct resulting from chronic cholecystitis.