A nurse cares for a teenage girl with a new ileostomy. The client ...

[olgavictoria]

A nurse cares for a teenage girl with a new ileostomy. The client states, I cannot go to prom with an ostomy. How should the nurse respond?
 
  a. Sure you can. Purchase a prom dress one size larger to hide the ostomy appliance.
  b. The pouch won't be as noticeable if you avoid broccoli and carbonated drinks prior to the prom.
  c. Let's talk to the enterostomal therapist about options for ostomy supplies and dress styles.
  d. You can remove the pouch from your ostomy appliance when you are at the prom so that it is less noticeable.

Question 2

A nurse assesses a client who is hospitalized with an exacerbation of Crohn's disease. Which clinical manifestation should the nurse expect to find?
 
  a. Positive Murphy's sign with rebound tenderness to palpitation
  b. Dull, hypoactive bowel sounds in the lower abdominal quadrants
  c. High-pitched, rushing bowel sounds in the right lower quadrant
  d. Reports of abdominal cramping that is worse at night

[tjayeee]

Answer to Question 1

ANS: C
The ostomy nurse is a valuable resource for clients, providing suggestions for supplies and methods to manage the ostomy. A larger dress size will not necessarily help hide the ostomy appliance. Avoiding broccoli and carbonated drinks does not offer reassurance for the client. Ileostomies have an almost constant liquid effluent, so pouch removal during the prom is not feasible.

Answer to Question 2

ANS: C
The nurse expects high-pitched, rushing bowel sounds due to narrowing of the bowel lumen in Crohn's disease. A positive Murphy's sign is indicative of gallbladder disease, and rebound tenderness often indicates peritonitis. Dullness in the lower abdominal quadrants and hypoactive bowel sounds are not commonly found with Crohn's disease. Nightly worsening of abdominal cramping is not consistent with Crohn's disease.

[olgavictoria]

Excellent

[pratush dev]

TYSM