The client who is 2 days postoperative after colostomy surgery is hesitant to look at the stoma. Which is the best client response for the nurse to provide?
1. "It looks very good for a new colostomy.".
2. "I will teach stoma care to a family member.".
3. "I will explain the procedure as it progresses.".
4. "You must look at it eventually, why not now?"
3
3. The nurse avoids forcing the client to look at the stoma because the client is 2 days postoperative and because clients adjust to enterostomies at different rates and by different methods. The client is not ready to look at the ostomy, so the nurse explains the steps of the procedure while performing care. By doing so, the nurse continues to engage the client in the care without forcing the client to look at the stoma. Explain-ing the procedure is important for the client having difficulty adjusting to the stoma and for the client who is weak from surgery and needs the interaction.
1. The client can interpret the nurse's comment as coercion to look at the stoma by stating it looks good; however, depending on the tone of the nurse's voice and the time this message is delivered, the client can be comforted by this comment.
2. Deferring stoma care to a family member is premature at this point.
4. The nurse's comment is likely to humiliate or shame the client and is a counter-productive intervention likely to delay client acceptance of the stoma rather than hasten it.
You might also like to view...
The nurse is teaching the client how to administer insulin before discharge. The nurse teaches the safest and most effective sites for insulin injection. The nurse is demonstrating which of the following?
1. The psychomotor domain 2. The cognitive domain 3. Demonstration and role modeling 4. Adaptation to changing health status
When assisting the health care provider to perform a lumbar puncture, the nurse would place the client in which position?
a. dorsal recumbent c. prone b. lithotomy d. side-lying, knee-chest
The order for the five basic techniques of physical examination is the same in all regions of the body except the abdomen. What is the proper order of the techniques for examining all regions except the abdomen?
1. palpation, inspection, auscultation, percussion 2. inspection, palpation, percussion, auscultation 3. inspection, palpation auscultation percussion 4. percussion, palpation, inspection, auscultation
Which food or beverage should you teach a patient who is prescribed quetiapine (Seroquel) to avoid?
a. Coffee and caffeine b. Fresh berries and vegetables c. Aged cheese and smoked meat d. Grapefruit and grapefruit juice