A nurse is reinforcing teaching about home safety with the parent of an 8-month-old infant. Which of the following statements by the parent indicates an understanding of the teaching?

b. "You can use an adhesive remover when changing the colostomy skin barrier."

The nurse should inform the client that they can use an adhesive remover when changing the colostomy skin barrier. Adhesive removers are helpful in gently removing the adhesive residue left behind by the previous ostomy appliance. This can make the process of changing the colostomy skin barrier more comfortable for the client and help prevent skin irritation or damage.

Explanation for the other options:

a. "You should scrub the skin around the colostomy when cleaning." Scrubbing the skin around the colostomy can be harsh and may cause skin irritation or damage. It is recommended to clean the peristomal skin gently using mild soap and water, followed by thorough drying.

c. "You will need a device to suction stool from the colostomy bag." Suctioning stool from the colostomy bag is not a routine procedure for colostomy care. Colostomy bags are designed to collect stool, and emptying the bag as needed is the appropriate method of management.

d. "You should empty the colostomy bag when it is three-fourths full." The timing of emptying the colostomy bag may vary for each individual. It is generally recommended to empty the colostomy bag when it is one-third to one-half full to prevent leakage or discomfort. The client should be educated on monitoring the bag and emptying it as necessary based on their own output and comfort level.

b. Monitor the client for 15 min after meals.

Explanation:

The correct answer is b. Monitor the client for 15 min after meals.

Anorexia nervosa is a serious eating disorder characterized by self-imposed starvation and a distorted body image. When planning care for a client with anorexia nervosa, it is important to focus on interventions that promote safety, nutritional rehabilitation, and psychological support.

Option a is not the correct answer. Encouraging the client to gain 2.3 kg (5 lb) per week is not a realistic or healthy goal for weight gain in the context of anorexia nervosa. Rapid weight gain can be physically and psychologically overwhelming for the client and may reinforce disordered eating behaviors.

Option c is not the correct answer. Weighing the client each morning after voiding may contribute to obsessive monitoring of weight, which is a common feature of anorexia nervosa. Frequent weigh-ins can exacerbate anxiety and fixation on numbers, which are detrimental to the client's recovery.

Option d is not the correct answer. Reinforcing teaching about healthy eating during meals is not an appropriate intervention for a client with anorexia nervosa. Anorexia nervosa involves a distorted perception of body weight and shape, as well as deeply ingrained beliefs and fears related to food. Focusing on teaching about healthy eating during meals may trigger anxiety and reinforce disordered thoughts and behaviors.

By recommending the intervention to monitor the client for 15 minutes after meals, the nurse ensures close observation during a critical time when the client may engage in compensatory behaviors such as purging or exercising excessively. This intervention allows for immediate identification of any concerning behaviors and provides an opportunity for therapeutic intervention, support, and redirection.

It is crucial to approach care for clients with anorexia nervosa with sensitivity and an understanding of the complex psychological and physiological challenges they face. The chosen intervention focuses on the immediate post-meal period and aims to promote safety and support the client in their recovery journey.