UP NHM CHO 7 Sept 2022(shift-1st)
Medical Surgical Nursing
Easy
The skin barrier applied on a stoma primarily contains:
Appeared in: UP NHM CHO 7 Sept 2022(shift-1st)
Explanation
- Zinc oxide is a key ingredient in many stoma care products, especially protective pastes and powders.
- It functions as a physical protectant, forming an inert, occlusive barrier on the skin.
- This barrier shields the sensitive peristomal skin from the irritating enzymes and moisture found in stoma effluent (urine or feces).
- Sources describe zinc oxide as a soothing and protective agent with mild astringent and antiseptic properties, ideal for protecting vulnerable or damaged skin, similar to its use in diaper dermatitis.
Why Other Options Were Wrong
- Option B: Sulphur dioxide is a toxic gas and an environmental pollutant; it has no therapeutic use in skin or stoma care.
- Option C: Calcium phosphate is the primary mineral component of bones and teeth. It is not used as a topical agent for skin protection.
- Option D: Glycerine is an emollient and humectant that moisturizes the skin by attracting water. It does not form the necessary physical, water-repellent barrier to protect skin from corrosive stoma output.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Composition and function of peristomal skin barriers in stoma care as background academic context rather than a clinical decision trigger.
- Protecting the peristomal skin is a fundamental aspect of stoma care. Failure to do so can lead to painful and difficult-to-manage complications like peristomal moisture-associated skin damage (MASD), fungal infections, and chemical irritation.
- Nurses must educate patients on the correct application of skin barriers and powders to ensure a good seal and prevent leakage, which is the primary cause of skin breakdown.
- What if? If the peristomal skin is already denuded and weeping, the nurse should first apply a light dusting of stoma powder (which often contains zinc oxide) to the affected area, brush off the excess, and then apply the skin barrier. This technique, known as 'crusting,' helps create a dry surface for the barrier to adhere to and promotes healing.
How to Approach the Question
- First, understand the purpose of a skin barrier for a stoma: to protect the skin from the irritating effects of bodily waste (effluent).
- Analyze the function of each substance listed in the options in the context of skin application.
- Zinc oxide is known as a physical barrier (like in sunscreens and diaper rash creams). This aligns with the protective function needed.
- Sulphur dioxide is a known toxic substance, immediately ruling it out.
- Calcium phosphate is related to bone structure, not topical skin protection.
- Glycerine is a moisturizer (humectant), which attracts water. This is generally not the primary goal when trying to protect skin from constant moisture and corrosive enzymes.
Concept Tested & Keywords
- Concept Tested: Composition and function of peristomal skin barriers in stoma care.
- Stem keywords: skin barrier, stoma
- Lead-in keywords: primarily contains
Question ID
QI-5vhAhSvvILflXzlZ8BS
Reference Book
E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 229-231
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1848-1850
Practise the full UP NHM CHO 7 Sept 2022(shift-1st)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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