The nurse irrigates the client's sigmoid colostomy. Which does the nurse observe to realize effective therapy?
1. The client reports passing large amounts of stool between irrigations.
2. The client has moderate abdominal cramping but no stool evacuation.
3. The client expels the irrigating solution and stool 1 hour after irrigation.
4. The client has a second stool evacuation 30 to 60 minutes after irrigation.
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4 and 3. Thirty to sixty minutes after completing the procedure, the client reports a stool evacuation, indicating effective irrigation because the nurse expects a secondary stool evacuation after irrigation. The secondary stool evacuation expels remaining stool in the colon, increasing the likelihood that the ostomy is empty.
2. The irrigation solution is not intended for retention; in fact, the irrigation equip-ment is designed to empty into the commode during the irrigation.
1. The purpose of irrigation is to empty the colon and maintain regular bowel evacua-tions; if the irrigation does not result in stool evacuation, the irrigation is ineffective because it did not achieve its goal.
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