COCN Exam Review 1 Study Guide Solutions Updated

COCN Exam Review 1 Study Guide Solutions Updated Methotrexate - ANSWER-This drug is used in steroid-dependent, active Crohn's disease and in Crohn's disease remission maintenance. There is no evidence to support its use for ulcerative colitis. c - ANSWER-Mr. F. has returned to the outpatient clinic for follow-up two weeks after discharge. He has an enterocutaneous fistula to his upper abdomen. The fistula is 1 cm in diameter and drains 500-600 ml of liquid green effluent every 24 hours. He is achieving a 3-day wear time using a standard ostomy pouching system. Upon removal of the pouching system there is denudement at the 6 o'clock position where the patient has a small but deeply scarred defect. Your recommendation would be to: a. Cut the skin barrier opening to slightly less than 1cm b. Change to a high output pouching system c. Level the skin defect with skin barrier paste or ring d. Continue his current plan of care without modifications Laxatives - ANSWER-__________________ should never be used by a person with an ileostomy because of the potential for severe dehydration and electrolyte imbalance. Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024 Copyright ©Stuvia International BV Page 2/25 peristomal pyoderma gangrenosum - ANSWER-idiopathic, inflammatory ulcerative condition of the peristomal skin. It is thought to start as one or more pustules that break open and form full-thickness ulcers. The surrounding skin becomes red and purple. a (The principles of PG wound care include pain management, moisture control and maintenance of a clean wound base, protection of the wound base, delivery of topical anti- inflammatory/immunosuppressive preparations, and achieving a predictable pouching system wear time of at least 24 hours) - ANSWER-Which of the following treatments is appropriate for a patient with a full-thickness lesions from peristomal pyoderma gangrenosum? a. topical steroids b. topical antifungals c. topical antibiotics d. silver nitrate cauterization vesicovaginal fistula - ANSWER-an abnormal connection between the bladder and the vagina 60 - ANSWER-An important aspect of caring for a neobladder is the prevention of the accumulation of mucous in the pouch. Individuals should be taught to instill _____ ml of normal saline and allow it to drain. Repeat until clear. self-efficacy - ANSWER-Focusing on promoting ________________ with individuals with psychological problems has been shown to improve self-care. viral gastroenteritis - ANSWER-Small meals of bland, low residue foods and adequate fluids are recommended for acute _________________________________ to meet the patient's dietary needs. Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024 Copyright ©Stuvia International BV Page 3/25 Ideal food choices include boiled starches (rice, wheat, oats) and vegetables, crackers, bananas, soup and yogurt 6-8 weeks - ANSWER-Gastrostomy and jejunostomy devices are placed when enteral nutritional support (tube feeding) is required long-term, generally more than ________________. jejunostomy - ANSWER-A _________________ tube is superior to a gastrostomy tube in patients with high aspiration risk; esophageal or gastric cancer; previous gastric, duodenal, or pancreatic surgery; or severe gastric paresis bladder cancer - ANSWER-Your patient has had an orthotopic bladder replacement. This procedure is done for _________________. electric razor - ANSWER-If the abdomen has a lot of hair, which can cause pain with pouch changes and folliculitis, hair removal with a(n) ______________________________ is recommended. Turnbull blowhole colostomy - ANSWER-The ____________________________ is occasionally indicated for extremely ill patients with severe toxic megacolon. It is done for simplicity and its ability to rapidly reduce sepsis. True - ANSWER-True or False: A Turnbull blowhole colostomy procedure leaves the diseased colon behind, leading to persistent toxicity. antidiarrheal - ANSWER-_______________________ agents are contraindicated for infectious enteritis because the organisms become retained in the bowel and cause more reaction. d - ANSWER-You are reviewing a list of medications with your patient who is about to be discharged after having an emergent loop transverse colostomy. One of the medications is Wellbutrin XL, a sustained-released antidepressant that the patient has taken for the past 3 years. You decide to: Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024 Copyright ©Stuvia International BV Page 4/25 a. Encourage the patient to keep taking this medication. b. Review the side effects of the medication with the patient. c. Ask the physician to discontinue the medication. d. Determine if the colostomy has a high output odor - ANSWER-Low output fistulas (less than 150 ml/24 hours) within a large wound may best be managed using skin protection and dressings. ____________ management should be a priority. low constant suction - ANSWER-Connection of a pouching system to ____________________ is indicated if the volume of drainage overwhelms and loosens the seal. neobladder - ANSWER-A ___________________ can have a particular advantage for obese patients, since the thickness of their abdominal wall can make creation and management of a cutaneous stoma more difficult. orthotopic neobladder - ANSWER-Contraindications to an ________________________________ include urethral pathology, impaired renal or hepatic function, and inability to perform self- catheterization due to physical or mental impairment. ileum - ANSWER-Crohn's disease may affect any part of the GI system, especially the __________. decreasing - ANSWER-Peristomal folliculitis generally results from shaving of the peristomal skin, friction, and in some cases occlusion. It may be reduced by __________________ the frequency of shaving, lightly shaving in the direction of hair growth, clippin