Question

A client is admitted to the hospital following a gunshot wound to the abdomen. A temporary colostomy is performed, and the physician writes an order to irrigate the proximal end of the colostomy. The nurse is aware that the proximal end of a doublebarrel colostomy is the end that: A. Is the opening on the client's left side B. Is the opening on the distal end on the client's left side C. Is the opening on the client's right side D. Is the opening on the distal right side

Short answer

Answer: C. The opening on the client's right side

Step-by-step solution

Understanding the question

First, we need to understand the situation described in the question. A client has been admitted to the hospital with a gunshot wound in the abdomen and has undergone a temporary colostomy. The question asks us to identify the proximal end of a double-barrel colostomy, which is the end that needs to be irrigated according to the physician's order.

Understanding the colostomy

A double-barrel colostomy involves creating two stomas (openings) in the abdomen after the removal of a portion of the colon. One stoma is the proximal end, which is connected to the working part of the colon. The other stoma is the distal end, which is the non-functioning, inactive part of the colon. It is crucial to differentiate the proximal end from the distal end for proper care and management of the condition.

Reviewing the options

Now, let's look at the choices provided: A. The opening on the client's left side B. The opening on the distal end on the client's left side C. The opening on the client's right side D. The opening on the distal right side

Identifying the correct choice

Based on our understanding of a double-barrel colostomy, the proximal end is the functioning part of the colon. Considering the options given, the correct answer is: C. The opening on the client's right side As the proximal end is typically the stoma on the patient's right side that connects to the functioning part of the colon, which will allow for proper irrigation as instructed by the physician.

Key concepts

Colostomy Care

Caring for a colostomy is an essential skill for patients and healthcare providers alike after a portion of the colon has been surgically diverted through an opening in the abdomen. Understanding the anatomy and function of the double-barrel colostomy is the starting point.

The proximal stoma, which is the functioning end that expels feces, requires regular cleaning and irrigation to prevent infections and blockages. This is typically located on the patient's right side. The stoma should be checked at regular intervals for signs of redness, swelling, or skin breakdown.

Adhesive barriers and a properly fitting ostomy bag are imperative to protect the skin and manage waste. Patients are also educated on how to measure their stoma, as its size may change over time post-surgery. Dietary changes, like avoiding high-fiber foods immediately after surgery, can also help manage stoma function and output. It's vital to teach patients and caregivers comprehensive colostomy care to promote healing and prevent complications.

Nursing Management Post-Surgery

After a colostomy surgery, nurses play a pivotal role in the patient's recovery and long-term management.

Postoperative care includes monitoring vital signs, managing pain, and assessing the stoma's appearance and output. Nurses ensure that the stoma is functioning as expected and that no signs of complications like ischemia or necrosis are present.

One crucial aspect is patient education. Nurses instruct on how to care for the stoma, recognize signs of infection, and when to contact the healthcare provider. They also provide emotional support, as adapting to life after a colostomy can be challenging for patients. Infection control protocols must be strictly followed, which includes hand hygiene and using sterile techniques during colostomy care. Keeping the skin around the stoma clean and dry is also essential to prevent irritation and breakdown.

Gastrointestinal Nursing

Gastrointestinal nursing encompasses a wide range of responsibilities, from understanding complex digestive system pathologies to providing education on digestive management and postoperative care.

Nurses specializing in this area must be knowledgeable about various gastrointestinal procedures, like colostomies, and the implications of these surgeries.

They assess digestive functioning, monitor for complications, and implement interventions to maintain optimal GI health. This includes administering medications, providing nutrition advice suited to the patient's condition, and assisting in procedures such as colostomy irrigation. Effective gastrointestinal nursing blends technical skills, patient education, and a compassionate approach to ensure the well-being of patients with a wide array of GI conditions.