Auscultate for bowel sounds Ensures continued peristalsis Observe family and patient for nonverbal behaviors. Ask patient and family if they have any questions Determines level of understanding of the procedure
Positive bowel sounds
Patient verbalizes understanding of procedure
Family and patient may have unan- swered ques- tions
Patient
may be unable to independ- ently care for the colostomy
Clinical Pause 1. Should a client with a colostomy have a shower? Answer:Yes, the client may have a shower with or without the appliance. However, the client should avoid direct pressure on the stoma site and the skin needs to be dried thoroughly. If a pouch is worn, it may need to be reapplied because adhesion is decreased. 2. What types of nonverbal behaviors would indicate that the family and client were ready to learn about the colostomy? Answer: If the family or client looks at the stoma and ask questions, they are probably ready to learn. If they are apprehensive and cannot look at the site, they may need further counseling.
Care of the Patient with a Colostomy Debriefing questions are available online and cover the core topics that should be included in every debrief.
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Every scene or frame in every simulation is followed by simulation- specific Clinical Pause questions that allow you to pace the simulation, check students’ understanding, and refocus as necessary.
Clinical Pause 1 As a nurse, what could you do if the client and family refuse to look at the stoma?
Answer: Obtain information about ostomy support groups, refer the client and family to other volunteer agencies, or contact the WOCN at the hospital.
Debriefing/Guided Reflection Facilitator, refer to the debriefing/guided reflection ques- tions located the Appendix which appears in the Participant Volume and also on DavisPlus. References Deglin, J. H., & Vallerand, A. H. (2017). Davis’s drug guide for nurses (15th ed.). Philadelphia: F. A. Davis. Dillon, P. (2007). Nursing health assessment: A critical thinking and case studies approach (2nd ed.). Philadelphia: F. A. Davis. Erikson, E. H. (1950). Childhood and society . NewYork: Norton. .
Hoffman, J., & Sullivan, N. (2017). Medical-surgical nursing: Making connections to practice. Philadelphia: F.A. Davis. Lagerquist, S. L. (2012). Davis’s NCLEX-RN success. (3rd ed.). Philadelphia: F. A. Davis. Lutz, C. A., Mazur, E. E., & Litch, N. A. (2015). Nutrition and diet therapy (6th ed.). Philadelphia: F. A. Davis. Treas, L. S., &Wilkinson, J. M. (2017). Basic nursing (2nd ed.). Philadelphia: F. A. Davis. Van Leeuwen, A. M., & Bladh, M. L. (2017). Davis’s comprehensive handbook of laboratory and diagnostic tests with nursing implications (4th ed.). Philadelphia: F.A. Davis.
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