Answer to Question 1
D
D. Physiological normal saline is safest. Infants and children can tolerate only this type because of their predisposition to fluid imbalance. If solution is prepared at home, mix 500 ml (1 pint) of tap water with 1 teaspoon table salt.
A. Tap water (hypotonic) enema should not be repeated after first instillation because water toxicity or circulatory overload can develop.
B. Hypertonic solution is useful for clients who cannot tolerate large volumes of fluid. Only 120 to 180 ml (4 to 6 ounces) is usually effective (e.g., commercially prepared Fleet enema).
C. Oil retention enema uses an oil-based solution. Permits administration of a small volume, which is absorbed by the stool. The absorption of the oil softens stool for easier evacuation.
Answer to Question 2
D
The patient may shower without covering the pouch. Teach patients the significance and importance of drinking 1.5 to 2 quarts of fluid daily to prevent urinary tract infection. Patients should avoid storing pouches in extremely hot or cold locations like the refrigerator. Teach patients that some mucus in the urine is expected, but that they should report to their physician any blood in the urine, excessively cloudy urine, chills, fever (101F or higher), or back (flank) pain.
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