A client had surgery 2 weeks ago and now has a continent diversion. An appropriate technique for the nurse to implement is to:
A. Put on clean gloves
B. Aspirate before the irrigation
C. Prepare 20 to 30 ml of NS
D. Cleanse the peristomal skin with acetone
C
C. Pour 20 to 30 ml sterile NS into sterile specimen cup.
A. Perform hand hygiene, and open sterile equipment. Put on sterile gloves.
B. Do not aspirate because this increases risk of damage to internal suture lines. Irrigation maintains patency of stomal catheter because large amount of mucus is secreted initially by reservoir.
D. Using remaining povidone-iodine swabs, cleanse "face" of stoma around catheter. Use another swab, and cleanse skin around base of stoma; allow to dry 30 seconds and gently remove iodine with a gauze pad moistened with sterile water.
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