The practical nurse (PN) is assisting with preparation of a client for fecal diversion surgery. While inserting an indwelling urinary catheter, the client asks if the surgical opening will be visible.
Which action should the PN implement?
A.
Review the client’s expectations of elimination after surgery.
B.
Verify that the client had nothing by mouth (NPO) for the past 24 hours.
C.
Ask the client if he finished the bowel sterilization prescription.
D.
Determine if this is the first indwelling catheter the client has had.
The correct answer and Explanation is :
The correct answer is A. Review the client’s expectations of elimination after surgery.
Explanation:
In fecal diversion surgery, such as a colostomy or ileostomy, a stoma is created to allow feces to exit the body through an opening in the abdominal wall. When a client undergoing this type of surgery asks whether the surgical opening (stoma) will be visible, the question reflects concerns about their body image, postoperative care, and how elimination will change after surgery.
Why is A the correct action?
The Practical Nurse (PN) should assess and address the client’s understanding and expectations of the surgery and the changes in elimination that will follow. The client may be worried about the appearance of the stoma and how it will affect their daily life. By reviewing these expectations, the PN can clarify the nature of the procedure, explain that the stoma will be visible, and provide reassurance or guidance about stoma care. This helps to alleviate anxiety and prepare the client for life after surgery.
Why not the other options?
- B. Verify NPO status: While important for ensuring the client is ready for surgery, it does not directly address the client’s concern about the surgical opening and its visibility. This task is typically managed during preoperative checks by surgical teams, not necessarily the PN.
- C. Ask about bowel sterilization prescription: Asking whether the client has completed bowel preparation is relevant for surgery but unrelated to the client’s immediate concern. Like NPO status, this task is part of ensuring physical preparation for the surgery.
- D. Determine if this is the first indwelling catheter: This question addresses the catheter insertion rather than the client’s concern about the surgical opening, making it irrelevant to the client’s current worry about the surgery.
Addressing the client’s concerns and expectations is crucial for providing holistic, client-centered care.