A nurse is reinforcing teaching with an adolescent who has a new prescription for cefazolin.

For which of the following findings should the nurse instruct the adolescent to monitor and report to the provider?

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.

c. Initiate a client referral to Reach to Recovery.

Explanation:

When caring for a female client who has a new diagnosis of breast cancer and expresses concerns about potential changes to her body image, the nurse should initiate a client referral to Reach to Recovery. Reach to Recovery is a program provided by the American Cancer Society that connects breast cancer patients with trained volunteers who have gone through a similar experience. These volunteers can provide emotional support, information, and resources to help the client cope with the physical and emotional changes that may occur due to breast cancer and its treatment.

Explanation for the other options:

a .Reassure the client that she will adjust to changes to her body:

While providing reassurance is important, it may not be sufficient to address the client's concerns about potential changes to her body image. Initiating a referral to Reach to Recovery can provide the client with additional support and resources tailored to her specific needs.

b. Contact an occupational therapist to talk with the client:

While an occupational therapist may have valuable input on certain aspects of the client's care, such as functional abilities and adaptations, initiating a referral to Reach to Recovery would be more appropriate for addressing the client's concerns related to body image.

d. Explain that surgery can restore the breast to its original appearance:

While surgery options such as breast reconstruction can restore the breast to a similar appearance, it is not appropriate for the nurse to make guarantees about the outcome or appearance of the breast after surgery. Every individual's situation is unique, and the decision to undergo surgery and the results of such procedures are dependent on various factors. Referring the client to Reach to Recovery would be more beneficial in addressing her concerns holistically.

In summary, when a client with a new diagnosis of breast cancer expresses concerns about potential changes to her body image, the nurse should initiate a client referral to Reach to Recovery. This program can provide the client with the necessary emotional support and resources to navigate the physical and emotional changes associated with breast cancer and its treatment.