You are evaluating a 36 year-old male with a history of episodic angry outbursts (both verbal and physical), for more than 3 months, that occur impulsively and are described as “over-the top”. The outbursts of anger are at times unprovoked and the patient has suffered job and relationship loss due to these outbursts.  In between episodes he presents calmly and has some remorse following an episode. He endorses some marijuana and alcohol use socially. There is no significant medical or prior psychiatric history or diagnosis. What is the most appropriate diagnosis at this time?

A 30-year old patient, prescribed haloperidol for schizophrenia, presents with high fever, rigid muscles, and altered mental status. The nurse practitioner recognizes the symptoms. What should be the immediate action?

The patient who has a soft abdomen and a budded ileal conduit stoma will require what characteristic in the skin barrier surface of pouching system?

How many stools in a 24-hour period should the patient expect 3-6 months after a successful ileal pouch anal anastomosis (IPAA)?

Two long term complications associated with an ileal conduit include:

You have a patient who has had an ileal pouch anal anastomosis (IPAA) for 5 months. She is experiencing continent stools 8 times a day and her only complaint is that the perianal skin burns. Upon assessment, the perianal skin is intact, but erythematous. Which of the following interventions is most appropriate?

Bowel ischemia is a potential complication resulting from:

You have a patient with an ileal conduit who complains that the pouch leaks daily at the 9 o’clock location. With the patient in the supine position, you examine the patient’s abdomen and find the following: stoma is 1 ¼ inches round,  protrudes 1.5 cm, abdomen is flat and soft with no creases or scars present. The patient wears a flat one-piece 1 ¼” pre-cut urinary pouch with an integrated skin barrier. What should you do next?

A 2-month-old infant has been diagnosed with Hirschsprung’s disease and has a loop transverse colostomy. As a part of the teaching, the parents should be aware that:

Which of the following pouching system adaptations is MOST appropriate for the patient with a stomal prolapse?