Your teaching Anthony how to use his new colostomy. How much skin should remain exposed between the stoma and the ring of the appliance?
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Solution
1/16”
Only a small amount of skin should be exposed and more than 1/16” of skin allows the excrement to irritate the skin.
Anthony, a 60 y.o. patient, has just undergone a bowel resection with a colostomy. During the first 24 hours, which of the following observations about the stoma should you report to the doctor?
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Solution
Trickles of bright red blood.
After creation of a colostomy, expect to see a stoma that is pink, slightly edematous, with some oozing. Bright red blood, regardless of amount, indicates bleeding and should be reported to the doctor.
After an abdominal resection for colon cancer, Madeline returns to her room with a Jackson-Pratt drain in place. The purpose of the drain is to:
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Solution
Prevent accumulation of drainage in the wound.
A Jackson-Pratt drain promotes wound healing by allowing fluid to escape from the wound.
Glenda has cholelithiasis (gallstones). You expect her to complain of:
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Solution
Pain in the right upper quadrant, radiating to the shoulder.
The gallbladder is located in the RUQ and a frequent sign of gallstones is pain radiating to the shoulder.
Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes:
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Solution
Nutritional support with TPN.
With acute pancreatitis, you need to rest the GI tract by TPN as nutritional support.
Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by:
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Solution
Crampy and lower left quadrant pain and low-grade fever.
One sign of acute diverticulitis is crampy lower left quadrant pain. A low-grade fever is another common sign.
Regina is a 46 y.o. woman with ulcerative colitis. You expect her stools to look like:
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Solution
Bloody and mucous.
Stools from ulcerative colitis are often bloody and contain mucus.
Eleanor, a 62 y.o. woman with diverticulosis is your patient. Which interventions would you expect to include in her care?
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Solution
High-fiber diet and administration of psyllium.
She needs a high-fiber diet and a psyllium (bulk laxative) to promote normal soft stools.
A 29 y.o. patient has an acute episode of ulcerative colitis. What diagnostic test confirms this diagnosis?
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Solution
Sigmoidoscopy.
Sigmoidoscopy allows direct observation of the colon mucosa for changes, and if needed, biopsy.
Jerod is experiencing an acute episode of ulcerative colitis. Which is priority for this patient?
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Solution
Replace lost fluid and sodium.
Diarrhea d/t an acute episode of ulcerative colitis leads to fluid & electrolyte losses so fluid replacement takes priority.