A nurse is reinforcing discharge teaching about transmission precautions with a client who has hepatitis C. Which of the following information should the nurse include?

A. Notify the primary care provider of the results: Notifying the provider is important for persistent hypoxemia, but the nurse should first ensure the reading is accurate. Immediate action should confirm whether the low saturation reflects true hypoxemia or a measurement error.

B. Document the finding in the medical record: Documentation is part of standard care, but it does not address the potential acute hypoxemia. Recording should occur after verifying the reading and initiating appropriate interventions if needed.

C. Repeat the test on another finger: Pulse oximeter readings can be affected by poor perfusion, nail polish, cold extremities, or device malfunction. Repeating the test on a different finger or site helps confirm the accuracy of the measurement before taking further clinical actions.

D. Consult the respiratory therapist: Referral to a respiratory therapist may be indicated if hypoxemia persists, but it is not the first action. The nurse must first verify the accuracy of the SpO2 reading to determine whether urgent intervention is necessary.

A. "You can use an adhesive remover when changing the colostomy skin barrier.": Adhesive removers are appropriate to decrease trauma to the peristomal skin during appliance changes. Frequent removal of skin barriers can cause mechanical stripping, leading to irritation, denudation, and increased risk of infection. Using a gentle adhesive remover helps preserve skin integrity, which is essential for maintaining a proper seal and preventing leakage of effluent.

B. "You should scrub the skin around the colostomy when cleaning.": The peristomal skin should be cleaned gently with warm water and mild soap if needed, avoiding vigorous scrubbing. Scrubbing can cause friction injury and disrupt the epidermal barrier, increasing susceptibility to irritation from stool enzymes.

C. "You will need a device to suction stool from the colostomy bag.": Colostomy output drains passively into the pouch by gravity and peristalsis; suction devices are not used. Introducing suction could damage the stoma mucosa or disrupt the pouch seal. Routine care involves emptying and changing the appliance rather than mechanically removing stool.

D. "You should empty the colostomy bag when it is three-fourths full,": Colostomy pouches are generally emptied when they are one-third to one-half full to prevent excessive weight pulling on the skin barrier. Allowing the bag to fill to three-fourths increases the risk of leakage and detachment due to increased pressure and weight.