A client is recovering in the surgical unit 3 days after a permanent colostomy placement. The client refuses to look at the stoma, turns their head away during pouch changes, and states, "Just do what you have to do so I can go to sleep." Which actions by the practical nurse (PN) are appropriate to support the client's coping? Select all that apply.
- Provide a supportive, non-judgmental environment by actively listening if the client chooses to express their feelings.Answer
- BState, "Do not worry, many clients learn to manage a colostomy without any problems."
- Ensure the client's privacy by closing the door and drawing the curtains during ostomy care.Answer
- DAsk the client, "Why are you avoiding looking at the stoma when you will need to care for it soon?"
- EExplain to the client that they must progress through the specific stages of grief before they can achieve acceptance.
- Introduce small, manageable aspects of care, such as having the client simply hold a clean pouch.Answer
Answer
The appropriate actions are providing a supportive environment, ensuring privacy during care, and introducing small, manageable aspects of care.
The correct actions reflect therapeutic communication and appropriately paced nursing care. Providing a non-judgmental environment encourages the expression of feelings when the client feels ready. Ensuring privacy minimizes embarrassment and promotes dignity during a vulnerable time. Introducing small, manageable steps respects the client's current use of denial as a protective coping mechanism while gently moving them toward eventual adaptation and self-care.
Step-by-Step Solution
Key Concept
Coping Mechanisms and Therapeutic Communication