The nurse is instructing a client on ostomy care. What should be included in this teaching?
1. Change the drainage pouch daily.
2. Clothing of a special style will be needed now that a pouch is worn.
3. Stick a pin into the drainage pouch to relieve any gas buildup.
4. Secure the faceplate to the drainage pouch so no skin around the stoma is exposed.
Correct Answer: 4
Rationale 1: The drainage pouches are expensive, and they can be used for up to a week before being changed. Just daily rinsing and cleaning is necessary.
Rationale 2: No special clothing has to be worn with a colostomy pouch. The client can wear the same clothes he or she wore prior to the surgery.
Rationale 3: If a pin is stuck into the pouch, a hole will be left and it will cause leakage, which is not recommended.
Rationale 4: The skin around a stoma is very susceptible to irritation and breakdown. To avoid skin irritation, the faceplate to the drainage pouch needs to fit close enough to the stoma so as not to expose any other skin.
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Which of the following changes in integumentary system would be expected in the area of his wound? A) Profuse bleeding from removal of his epidermis B) Fewer Merkel and Langerhans cells in the region C) Exposure of the underlying subcutaneous tissue D) Removal of hair follicle roots from the area of the wound bed
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A) 24 B) 27 C) 30 D) 33
Which statement best describes the relationship between genes and chromosomes?
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A client who witnessed her husband being shot and killed in an incident of road rage says to the nurse, "It's been 3 months now, and I still can't drive my car without acting crazy. My sister says I grip the wheel like I'm glued to it. I can't merge with traffic until it's almost completely clear, and I'm parking a mile from in the mall when there's plenty of parking close to the building." Which statement by the nurse would be therapeutic?
A. "I still grip the wheel when I merge with traffic, and I just wonder whether your sister needs to see me do it." B. "If I were you, I'd have trouble driving the car again. Driving a car and being the victim of road rage are two very different things, and you need therapy and time to heal." C. "Smart of you to take no chances. You should see the dents and dings on my car from mall parking. Does your sister depend on you for many things? It seems like she's pushing you too hard." D. "You're seeking help appropriately, and there are many things you can do to get comfortable behind the wheel again. You've returned to driving, but remember, you're still grieving. It's normal to still feel this way."