# Situation: A 58-year-old man had a sigmoid resection with an end colostomy in the left lower quadrant (Hartmann procedure) for perforated diverticulitis. Before discharge, he asks about foods that affect stoma odor. Which statement shows that he understood the teaching?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630489  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 58-year-old man had a sigmoid resection with an end colostomy in the left lower quadrant (Hartmann procedure) for perforated diverticulitis.

Before discharge, he asks about foods that affect stoma odor. Which statement shows that he understood the teaching?

## 보기

1. "I will have yogurt or buttermilk with my meals." **✔ 정답**
2. "I will drink through a straw so less odor escapes."
3. "I will eat more eggs and fish to help my wound heal."
4. "I will add garlic and onions to mask the smell."

**정답: 1**

## 해설

Yogurt, buttermilk, parsley, and cranberry juice help reduce odor, while fish, eggs, onions, and garlic increase it. Drinking through straws, chewing gum, and eating quickly add swallowed air and gas.

## 심화 해설

Foods that reduce odor
Odor from a colostomy comes from the bacterial breakdown of certain foods in the colon. Some foods help control it: yogurt, buttermilk, parsley, and cranberry juice are commonly recommended to reduce stool odor. A client who says he will have yogurt or buttermilk with his meals has understood the teaching. Odor control combines choosing odor-reducing foods with limiting foods that increase odor. Modern pouches also contain odor-proof film and filters, so odor should be noticeable only when the pouch is emptied.

Foods and habits that make things worse
Fish, eggs, onions, and garlic increase stool odor, so adding garlic and onions to mask the smell has the opposite effect. Eating more eggs and fish for wound healing would increase odor; protein is important after surgery, but other sources such as poultry, lean meat, beans, or dairy can meet that need. Drinking through a straw, chewing gum, and eating quickly add swallowed air, which increases gas and pouch ballooning rather than reducing odor.

| Effect | Examples |
| --- | --- |
| Reduce odor | Yogurt, buttermilk, parsley, cranberry juice |
| Increase odor | Fish, eggs, onions, garlic |
| Increase gas from swallowed air | Straws, chewing gum, eating quickly |

Why the distractors sound convincing
Each wrong statement contains a reasonable-sounding idea: straws might seem to "contain" odor, garlic is used to mask smells in cooking, and protein truly does support wound healing. The nurse must recognize that the specific choices undermine odor or gas control. Watch out! Questions about ostomy diet often mix odor-producing foods with gas-producing habits; sort them before choosing.

Exam takeaway
Diet teaching after colostomy emphasizes a normal balanced diet, adequate fluids, chewing food well, and introducing foods one at a time to see their effect. Key point! Yogurt and buttermilk reduce odor; fish, eggs, onions, and garlic increase it; straws and gum add gas.

## 임상 시나리오

Colostomy Odor and Gas ControlDiet teaching before discharge
Foods that reduce odor: yogurt, buttermilk, parsley, and cranberry juice.

Foods that increase odor: fish, eggs, onions, and garlic. Choose other protein sources for wound healing.

Straws, chewing gum, and eating quickly add swallowed air and gas.

## 핵심 개념

- **Colostomy** — A surgical opening of the colon onto the abdominal wall through which stool exits into a pouch.
- **Swallowed air** — Air taken in while eating or drinking that increases intestinal gas and pouch ballooning.
- **Pouch filter** — A charcoal vent on an ostomy pouch that releases gas while absorbing odor.

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