Certified Medical-Surgical Registered Nurse Practice Test

When changing Mrs. Warren's ileostomy bag, the nurse notices that the peristomal skin is irritated. Which action by the nurse would be appropriate before reapplying the appliance?

1. Obtain an order for a topical antibiotic.

2. Use a solid skin barrier.

3. Wash the area with antiseptic soap and water.

4. Clean the site with Dakin's solution.

The correct answer is: Use a solid skin barrier.

When changing the ileostomy bag and noticing that the peristomal skin is irritated, using a solid skin barrier would be the most appropriate action before reapplying the appliance. A solid skin barrier helps to protect the irritated skin from further damage by providing a barrier between the skin and the adhesive of the ostomy appliance. This can help promote healing of the irritated area and prevent further skin breakdown. The other options are not the most appropriate in this situation: - Obtaining an order for a topical antibiotic may be necessary in certain cases of infection but is not the first-line intervention for irritated peristomal skin. - Washing the area with antiseptic soap and water may further irritate the skin due to the harshness of the antiseptic soap. - Cleaning the site with Dakin's solution is too harsh for the peristomal skin and can cause more irritation.