The skin barrier covering a client's intestinal fistula keeps falling off when she stands up to

ambulate. The nurse has reapplied it twice during the shift, but it remains intact only when

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the client is supine in bed. The nurse telephoned the physical therapist about the difficulties

containing the drainage from the fistula, so the therapist didn't ambulate the client today.

The client sat in a chair during lunch w/an absorbent pad over the fistula. The client ate all

the food on her tray. The wound care nurse confirmed that she will see the client later today.

The client states she feels frustrated at not having physical therapy, but the nurse thinks the

client welcomed having a day to rest. Which of the following information should the nurse

include in the change-of-shift report? Select all that apply.

A. The physical therapist didn't ambulate the client today

B. The skin barrier's seal stays on in bed but loosens when the client stands.

C. The client seemed to welcome having a "day off" from physical therapy

D. The wound care nurse will see the client later today

E. The client ate all the food on her lunch tray

A, B, D

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