The nurse is completing discharge teaching with a patient following an ileostomy. Which statement by the patient indicates the need for more teaching concerning the ileostomy?

"I can still participate in physical activities and exercise with an ileostomy."

"I should empty the pouch when it is about two-thirds full."

"I should apply adhesive remover to the skin around the stoma when changing the pouch."

"I can eat all my favorite foods now that I have an ileostomy."

Answer and Explanation

The Correct Answer is D

A. This is an appropriate statement. Most patients with an ileostomy can resume physical activities and exercise, though they should be mindful of their stoma and pouch during activities.
B. This is a correct statement. The pouch should be emptied when it is about one-third to one-half full to prevent it from becoming too heavy or causing skin irritation.
C. This is also correct. Adhesive remover can be used to gently remove the pouch and adhesive, preventing irritation to the skin around the stoma.
D. This statement indicates a need for more teaching. While many foods can be eaten after an ileostomy, some foods may cause blockages or discomfort (e.g., nuts, seeds, and high-fiber vegetables). Patients need to be educated on dietary modifications and precautions post-ileostomy.

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Correct Answer is D

Explanation

A. While obesity can contribute to various health issues, it is not a direct cause of esophageal varices.
B. Smoking is harmful to overall health, but it is not specifically known to cause esophageal varices.
C. High blood pressure, especially systemic hypertension, is not a direct cause of esophageal varices. However, portal hypertension, which can be caused by liver disease, is the main factor in the development of esophageal varices.
D. Chronic liver disease, particularly cirrhosis, leads to portal hypertension, which in turn causes the veins in the esophagus to become engorged and prone to bleeding, resulting in esophageal varices. This is the most appropriate cause for esophageal varices.

A. Brush the client's teeth with a suction toothbrush every 12 hr. B. Provide humidity by maintaining moisture within the ventilator tubing. C. Position the head of the client's bed in the flat position. D. Turn the client every 4 hr.

Correct Answer is A

Explanation

A. Brushing the client's teeth with a suction toothbrush every 12 hours is a key intervention to reduce the risk of ventilator-associated pneumonia (VAP). Oral hygiene helps to decrease the accumulation of bacteria in the mouth, which could potentially be aspirated into the lungs and cause infection. This should be done more frequently, often every 4–6 hours, to reduce bacterial colonization.
B. Providing humidity to the ventilator tubing is necessary to maintain adequate moisture and prevent airway dryness, but it does not directly reduce the risk of VAP. Oral care and head-of-bed positioning are more crucial in preventing infection.
C. The head of the client's bed should be kept elevated, not flat, to reduce the risk of aspiration, which can lead to VAP. Keeping the head of the bed at a 30–45 degree angle is recommended.
D. Turning the client every 4 hours is important for preventing pressure ulcers and promoting circulation but is not the most effective intervention for reducing the risk of VAP. Frequent oral care and appropriate positioning are more important.

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The nurse is completing discharge teaching with a patient following an ileostomy. Which statement by the patient indicates the need for more teaching concerning the ileostomy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching student nurses about different types of medical conditions that affect the gastrointestinal system, when a student asks her about the cause of esophageal varices. What is an appropriate answer by the nurse when asked about a potential cause of esophageal varices?

Correct Answer is D

Explanation

A nurse is caring for a client who has an endotracheal tube and is receiving mechanical ventilation. Which of the following actions should the nurse take to reduce the risk of ventilator-associated pneumonia?

Correct Answer is A

Explanation

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