Chapter 26: The Patient with an Ostomy (all solved)

1. Which term appropriately defines an artificial opening into a body cavity? a. Gastrostomy b. Ostomy c. Colonoscopy d. Ureterostomy correct answers ANS: B An ostomy is an artificial opening into a body cavity. DIF: Cognitive Level: Knowledge REF: p. 414 OBJ: 3 TOP: Terminology KEY: Nursing Process Step: Implementation 2. Why is a patient who has undergone a colostomy instructed to measure the width of the stomas for the first 6 weeks postoperatively before applying each new pouch? a. The stoma will shrink during this time. b. A poor-fitting pouch will cause infection of the stoma. c. The paste will not adhere. d. Prolapse will result. correct answers ANS: A During the first 6 weeks, the stoma normally shrinks. The pouch needs to fit as closely to the stoma as is comfortable and safe to prevent skin irritation. DIF: Cognitive Level: Comprehension REF: p. 427 OBJ: 4 | 7 TOP: Pouch Fit KEY: Nursing Process Step: Implementation 3. A 47-year-old patient with a permanent colostomy reports some abdominal discomfort and rigidity 3 days after surgery. Which assessment should the nurse report and record? a. Vital signs are temperature, 100° F; pulse, 92 beats/min; and blood pressure, 160/98 mm Hg. b. Stoma is swollen and red; small amount of blood is observed at the base. c. Pouch has drained 110 mL of green-brown liquid, oozing from the pouch edges. d. Stoma is protruding. correct answers ANS: A Vital signs, in conjunction with the complaint of abdominal discomfort, should be reported and recorded as possible signs of impending peritonitis. DIF: Cognitive Level: Application REF: p. 423 OBJ: 4 TOP: Signs of Peritonitis KEY: Nursing Process Step: Implementation 4. A nurse is aware that many patients with ostomies have an altered self-image. What might this cause? a. Self-care deficits b. Sexual dysfunction c. Nonadherence to diet d. Irrational anger correct answers ANS: B A damaged self-image or body image may cause patients with ostomies to feel unattractive and embarrassed about possible sexual activity. Open-ended questions assist the patient to talk about their feelings.