Author Question: A home health nurse is evaluating a client who had a colostomy placed 6 weeks ago for the treatment ... (Read 65 times)

segrsyd · **on:** Jun 25, 2018

A home health nurse is evaluating a client who had a colostomy placed 6 weeks ago for the treatment of ulcerative colitis. Which assessment will cause the nurse to conclude that teaching goals for this client have been met?

A) A colostomy pouch that is clean and dry
B) Vital signs that reveal a normal temperature
C) A stoma that is pink and intact
D) The client experiences pain with certain types of food.

Question 2

A nurse caring for a pediatric client with inflammatory bowel disease (IBD) understands that there are variances in the presentation of IBD between children and adults. Which variances does the nurse anticipate for this pediatric client?

Select all that apply.
A) Children suffer from Crohn disease more frequently than ulcerative colitis
B) Pediatric clients often present with fistulizing or stricturing disease.
C) Pediatric clients usually have colonic involvement.
D) Pediatric clients more often present with left-sided colitis.
E) IBD is more common in females than males in the pediatric population

karlss · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Answer: C

Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has had a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.

Answer to Question 2

Answer: A, C

The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement; the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.