The client who has undergone the creation of a colostomy has a nursing diagnosis of Disturbed body image. The nurse would evaluate that the client is making the most significant progress toward identified goals if the client:
A. Watch the nurse empty the colostomy bag.
B. Look at the ostomy site.
C. Read the ostomy product literature.
D. Practice cutting the ostomy appliance.
Correct Answer: D. Practice cutting the ostomy appliance.
The client is expected to have a body image disturbance after a colostomy. The client progresses through normal grieving stages to adjust to this change. The client demonstrates the greatest deal of acceptance when the client participates in the actual colostomy care. Each of the incorrect options represents an interest in colostomy care but is a passive activity. The correct option shows the client is participating in self-care.
Option A: Provide opportunities for patient/SO to view and touch stoma, using the moment to point out positive signs of healing, normal appearance, and so forth. Remind the patient that it will take time to adjust, both physically and emotionally.
Option B: Although integration of stoma into body image can take months or even years, looking at the stoma and hearing comments (made in a normal, matter-of-fact manner) can help the patient with this acceptance. Touching stoma reassures patient/SO that it is not fragile and that slight movements of stoma actually reflect normal peristalsis.
Option C: Provide an opportunity for the patient to deal with ostomy through participation in self-care. Independence in self-care helps improve self-confidence and acceptance of the situation. Plan/schedule care activities with the patient. Promotes a sense of control and gives a message that a patient can handle the situation, enhancing self-concept.
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