The nurse evaluates the client's stoma during the initial post-op period. Which of the following observations should be reported immediately to the physician?

Correct Answer: B

Rationale: A dark red to purple stoma may indicate compromised blood flow or ischemia, which requires immediate medical attention. This color change could be a sign of inadequate blood supply to the stoma tissue, leading to tissue damage or necrosis. Reporting this observation promptly is crucial to prevent further complications. Choices A, C, and D are not indicative of immediate medical concern. A slightly edematous stoma, oozing a small amount of blood, or not expelling stool may not be uncommon findings during the initial post-op period and can be managed without urgent intervention.

Correct Answer: B

Rationale: In assessing a stoma of a patient with a healthy, well-healed colostomy, the stoma is expected to appear red and moist. This indicates good perfusion and tissue viability. The red color signifies an adequate blood supply, and moisture indicates normal tissue hydration. Option A, pale, pink, and moist, is incorrect because a pale stoma may indicate poor perfusion. Option C, dark or purple colored, is incorrect as it can indicate ischemia or necrosis. Option D, dry and black, is incorrect as it suggests tissue death and poor blood supply, which are signs of complications that need immediate attention. In an educational context, understanding the normal appearance of a stoma is crucial for nurses caring for patients with ostomies. Recognizing abnormal findings can help in early identification of complications, prompt intervention, and prevention of further issues. This knowledge ensures optimal stoma care and patient outcomes.

Correct Answer: A

Rationale: In caring for a patient with a sigmoid colostomy, the correct answer is A) Formed stool. This is because a sigmoid colostomy is typically located in the descending or sigmoid colon, where water absorption primarily occurs. Therefore, the stool that passes through this colostomy tends to be more formed compared to colostomies located higher up in the colon, where more water absorption takes place. Option B) Semisolid and Option C) Semiliquid are incorrect because these consistencies are more commonly associated with colostomies located in the transverse or ascending colon, where less water absorption occurs, resulting in looser stool consistency. Option D) Watery is also incorrect as this consistency is more indicative of colostomies located in the proximal colon or small intestine, where minimal water absorption occurs, leading to watery stool output. Understanding the location of the colostomy and its impact on water absorption and stool consistency is crucial in providing appropriate care for patients with ostomies. Educating nursing students on these principles helps them make informed decisions regarding ostomy care and management based on the specific characteristics of the colostomy.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Yogurt. Yogurt is a good choice for individuals with a colostomy experiencing flatus issues because it contains probiotics that can help regulate the digestive system and reduce gas production. Probiotics promote a healthy balance of gut bacteria, which can improve digestion and decrease bloating and gas. Option A) Peas, Option B) Cabbage, and Option C) Broccoli are high-fiber foods that can increase gas production in individuals with a colostomy. These foods are known to produce more gas during digestion, leading to increased flatulence. Therefore, recommending these options to someone experiencing flatus issues may exacerbate their symptoms rather than alleviate them. From an educational perspective, it is essential for healthcare providers, especially those working with patients with colostomies, to have a good understanding of dietary recommendations that can help manage common issues such as flatus. Encouraging the consumption of yogurt with probiotics not only helps address the immediate concern of excessive gas but also promotes overall digestive health for individuals with colostomies. This knowledge empowers healthcare professionals to provide holistic care that considers both the medical condition and dietary factors impacting the patient's well-being.

Correct Answer: C

Rationale: In teaching ostomy self-care to a patient with a colostomy, it is crucial to ensure the correct sizing of the wafer to promote proper ostomy function and skin integrity. Option C, cutting the wafer about 1/8" larger than the stoma, is the correct choice. This additional space allows for a secure fit around the stoma without putting pressure on it, reducing the risk of leakage and skin irritation. Option A, cutting to the exact size of the stoma, can lead to the wafer being too tight, causing pressure on the stoma and potentially leading to necrosis or skin breakdown. Option B, cutting slightly smaller than the stoma, may not provide enough coverage, leading to leakage issues. Option D, cutting significantly larger than the stoma, can result in poor adhesion, leakage, and skin irritation due to exposed skin. Educationally, understanding the rationale behind correct ostomy wafer sizing is essential for nurses to effectively educate patients on self-care practices. It ensures optimal patient outcomes, promotes independence in managing their ostomy, and prevents complications. Providing clear and accurate instructions empowers patients to maintain their ostomy effectively, improving their quality of life and overall well-being.