A nurse is reinforcing teaching with a newly licensed nurse who is caring for a client who has AIDS. The nurse should instruct the newly licensed nurse to clean spills of the client's blood with a solution of water and which of the following cleaning agents?

Choice A Reason:

"I will use a skin sealant before I apply the bag." This statement is appropriate. Using a skin sealant before applying the ostomy bag helps protect the skin around the stoma, creating a barrier against irritation and potential leaks from the stool. It demonstrates the client's understanding of preventive measures to maintain skin integrity.

Choice B Reason:

"I will use moisturizing soap to clean around the stoma before applying the bag." This statement is inappropriate. While keeping the area around the stoma clean is important, using moisturizing soap might not be recommended as it can leave residue and interfere with the adhesive properties of the bag. Typically, mild soap and water are recommended for cleansing.

Choice C Reason:

"I will cut the wafer opening one-fourth of an inch larger than the stoma." This statement is incorrect. Cutting the wafer opening one-fourth of an inch larger than the stoma might result in an excessively large opening, potentially leading to leaks or irritation. The ideal size is generally recommended to be as close to the stoma size as possible without causing pressure on the stoma.

Choice D Reason:

"I will need to empty the bag every 4 to 6 hours." This statement is incorrect. While regular emptying of the ostomy bag is necessary, the frequency can vary based on individual needs and stoma output. Some individuals might need to empty it more frequently or less often, depending on their stool output and comfort level.

Choice A Reason

Using a hair dryer to blow hot air into the cast is not recommended. It can cause burns, soften the cast material, or create hot spots, potentially leading to skin damage or discomfort for the client.

Choice B Reason:

Perform neurovascular checks of the affected extremity every 2 hours is correct. Performing neurovascular checks regularly is crucial to assess the circulation, sensation, and movement of the affected extremity. This monitoring helps identify any signs of compromised blood flow or nerve function, which could indicate complications such as compartment syndrome.

Choice C Reason:

Positioning the fractured arm below the level of the client's heart is not advisable. Elevating the injured limb above heart level can help reduce swelling and promote blood flow, aiding in the healing process and preventing complications like swelling-related discomfort or decreased circulation.

Choice D Reason:

Immobilizing the client's fingers using a hand splint might not be necessary with a short arm cast. Typically, a short arm cast provides immobilization of the wrist and forearm while allowing some movement and function of the fingers unless specifically directed by the healthcare provider for individual circumstances.