Question

SCENARIO 1 You are caring for Miss Cassidy, age 50, in her own home. She was diagnosed with colon cancer four weeks ago. She had colon surgery and a permanent colostomy was created in the descending colon. She is very thin and has no appetite. She complains of lower back pain, has little energy and sleeps most of the day. She has a sister who lives several miles away but visits every second day. Miss Cassidy is very embarrassed about her colostomy. She says it smells and she can never predict when it will move. She has been taught to change the bags but requires constant reinforcement, assistance, and support.

Option 1

41. In caring for Miss Cassidy’s ostomy for hygiene you would:

a) Provide privacy, change when stool present, use gloves and deodorizers

b) Change once a day, gloves are not necessary unless there is a spill

c) Let her change it when she wants to and don’t worry about it, give her gloves

d) Only change it once a week or when it’s overflowing, use gloves and deodorizers

42. When assisting with ostomy care, you should:

a) Wash and dry the stoma and call the nurse to put on a new appliance

b) Clean the skin around the stoma with mild soap and warm water, rinse and pat dry

c) It’s not necessary to wash the stoma, just change the appliance

d) Wipe with a wet, cool cloth and put on a new appliance

43. Miss Cassidy wonders if her diet is affecting the consistency and frequency of her stools. As her PSW you would suggest that:

a) She should speak with the team care coordinator about her diet

b) She should keep track of how much meat she is eating daily

c) She shouldn’t worry about her diet; just concentrate on gaining some weight

d) Direct her to helpful on-line resources about colostomies and diet

Answer 1

Question 41.the answer is option a. Provide privacy, change when stool present, use gloves and deodorizers.

We should provide privacy and respect others privacy no matter what situation we are. We should think ourself in their shoes. In the above mentioned scenario miss Cassidy was worried about the stoma, has less confidence. The stoma bag should be ideally changed when it's full. Walking around with a full bag and changing it once a day can lead to peristomal skin excoriations and stoma infections. It should be changed when stools are present. Universal precautions to be used when touching any body fluids.

Question 42.the answer is option b. Wash the skin around the stoma with mild soap and warm water and pat dry. Stoma can be changed by o self, it is going to be a part of life so it isn't necessary to call the nurse. The stoma should be cleaned properly before fixing another bag.

Question 43. Tha answer is option a. She should speak with the team care coordinator about the diet. She should be aware about the diet she can exclude and the diet she should include which can be taught by the health care team.