Critical thinking Ostomy Care Scenario 2 You evaluate Ms. Jacob, a 65-year-old woman who had a colostomy 6 days ago for descending colon cancer. When...

Question Answered step-by-step Critical thinkingOstomy CareScenario 2You evaluate Ms. Jacob, a 65-year-old woman who had a colostomy 6 days ago for descending colon cancer. When she tells him that she is going to teach her to put on a new bag she starts crying and says “No, I don’t want to know how because she will go all over the place anyway.”1. Identify the initial nursing intervention and outline additional actions you would take to resolve this problem.2. Describe the evaluation database that you should complete before putting a plan in place. 3. Outline the steps in designing an education plan for the ostomy patient.choose an answer1.The patient will undergo diagnostic tests for fecal incontinence. For which of the following tests do you expect me to prepare the patient?a. Ultrasoundb. Electromyography.c. RM.d. Colonoscopy2. The patient is scheduled for surgery in the morning to have an ileostomy. He asks her what to expect when she returns from surgery. The best answer from her is: a. “You’ll have to talk to the doctor, I can’t tell you.” b. “There will be an opening in the abdomen where the stool will flow into a bag.”c. “A drain will be placed in the abdominal incision until bowel function returns.”d. “She will have a catheter inserted into the colon until the colon heals.”3. A major difference in the care of a patient with a colostomy and one with an ileostomy is:a. Ileostomy stools are liquid or semi-solid, requiring increased fluid intake. b. Only the patient with an ileostomy will need to use a colostomy bag.c. The ileostomy is usually able to be reversed when the disease disappearsd. There are usually no dietary restrictions with any of the patients.4. Just before removing the impacted stool, the nurse:a. Obtain an informed consent form for the procedure.b. Infuse at least 500 mL of fluid through the rectal tube into the lower part of the colon.c. Obtain baseline pulse and blood pressure. d. Give the patient a laxative to help remove stool.5. The patient demands a rectal suppository. Which of the following is appropriate when you put it on?a. Ask the patient to push when he introduces the suppository just distal to the external sphincter.b. Place the flat end of the suppository on the external sphincter.c. Introduce the suppository into the stool if possible.d. Place the pointed end of the suppository 7-10 cm beyond the internal sphincter.6. Contraindications to the Bowel Management System are: Select all correct.a. Recent reconstruction of the sphincter.b. Impacted or formed stools.c. Accentuated strictures in the distal area of ??the rectum or in the anal canal.d. History of severe diarrhea.7.Place the nursing actions in the order they should be performed when placing a BMS system.a. Gently pull and re-screw the catheter to (seal) the retention sleeve.b. Fill the syringe with 35-40 µL of warm water and insert it into the retention sleeve using the blue connector.c. Confirm that the probe balloon is fully collapsed.d. Hang the collection bag on the side of the bed.8. The patient has been ordered to administer an enema prior to surgery. Which of the following nursing actions would you do before giving a large volume enema?a. Place the patient on the right side in the Sim position. b. Teach the patient to take a deep breath and insert the tube 7-10 cm.c. Raise the height of the enema solution to the level of the patient’s shoulder.d. Instill the solution over 5-10 minutes.9. The student nurse has been instructed to educate the patient and family on the placement of a fecal ostomy bag. As you review the technique, identify what actions you would not consider appropriate to place it:a. Remove the old bag by pressing it against the skin while pulling on the skin.b. Clean the skin and stoma with warm water and a generous amount of soap.c. Cut the new bag at least 6 cm larger than the stoma without pulling on the edges.d. Attach the skin barrier ring to the opening in the bag.10. The nursing student is preparing to begin the main component of the nursing program. The student remembers that the adequate delegation of nursing techniques includes:a. Assign the nursing assistant to complete the removal of impacted stool from an elderly patient.b. Determine that non-certified ancillary personnel cannot be assigned to assist a patient requiring a tap water enema.c. Ask the nursing team leader to administer a carminative enema to the patient.d. Assign the LVN to develop an ileostomy education plan for the patient and family. Health Science Science Nursing NURS 230 Share QuestionEmailCopy link Comments (0)