A nurse is assessing a client who has a colostomy and notices that the stoma is pale in color. Which of the following findings should the nurse report to the provider?
The skin around the stoma is red.
The ostomy is draining frequently.
The stool is yellow-green.
The stoma is moist and pink.
The Correct Answer is A
A pale stoma can indicate poor blood flow, which is a serious concern that should be reported to the provider immediately. A healthy stoma should be moist and dark red or pink in color.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Discarding the dressing in the bedside trash receptacle is not recommended because it can lead to the spread of infection. The dressing is contaminated with blood and purulent drainage, which are considered biohazardous waste.
Choice B rationale
Double-bagging the dressing in clear bags and labeling it “biohazard” is not sufficient. While it’s important to label biohazardous waste, the dressing should be disposed of in a designated biohazardous waste container.
Choice C rationale
Enclosing the dressing in a single clear plastic bag and discarding it in the bedside trash receptacle is also not recommended. This method does not provide adequate containment for biohazardous waste.
Choice D rationale
Disposing of the dressing in a biohazardous waste container is the correct method. This ensures that the biohazardous waste is properly contained and reduces the risk of spreading infection.
Correct Answer is B
Explanation
Choice A rationale
A stoma may appear red and moist immediately after surgery, similar to the inside of the mouth. A purplish color could indicate a lack of blood supply to the stoma, which is a medical emergency.
Choice B rationale
A small amount of bleeding around the stoma is normal, especially when cleaning the area or changing the ostomy appliance. This is because the stoma contains blood vessels and has a rich blood supply.
Choice C rationale
Fecal output from a colostomy can be expected within 2 to 4 days after surgery. It is not typical to see output within 24 hours.
Choice D rationale
An increase in the intake of raw vegetables is not necessary after a colostomy. In fact, some people may find certain raw vegetables difficult to digest and they may cause gas or odor.
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