The nurse completes discharge instructions for a patient with a total laryngectomy. Which statement by the patient indicates that additional instruction is needed?
a. "I must keep the stoma covered with an occlusive dressing at all times."
b. "I can participate in most of my prior fitness activities except swimming."
c. "I should wear a Medic-Alert bracelet that identifies me as a neck breather."
d. "I need to be sure that I have smoke and carbon monoxide detectors installed."
ANS: A
The stoma may be covered with clothing or a loose dressing, but this is not essential. An occlusive dressing will completely block the patient's airway. The other patient comments are all accurate and indicate that the teaching has been effective.
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