A nurse is assessing a client 8 hours after the creation of a colostomy. Which assessment finding should the nurse expect?
Presence of hyperactive bowel sounds
Absence of drainage from the colostomy
Dusky-colored, edematous-appearing stoma
Red bloody drainage from the nasogastric tube
The Correct Answer and Explanation is:
Correct Answer: Absence of drainage from the colostomy
Explanation:
In the immediate postoperative period following colostomy creation—especially within the first 8 hours—it is normal and expected for there to be no drainage from the colostomy. The bowel needs time to resume peristalsis and recover from anesthesia and surgical manipulation. This temporary absence of output (often referred to as postoperative ileus) can last for 24–48 hours. Therefore, the absence of drainage at 8 hours post-operation is not concerning and is considered a normal finding.
Let’s analyze the other options:
- Presence of hyperactive bowel sounds:
This is not expected immediately after colostomy surgery. Postoperative ileus is common, and bowel sounds are often diminished or absent initially. Hyperactive sounds would be unusual this early and could suggest irritation or other issues such as obstruction once peristalsis resumes. - Dusky-colored, edematous-appearing stoma:
This is an abnormal and concerning finding. A healthy stoma should be pink to red and moist, indicating good blood flow. A dusky, dark, or purple color suggests ischemia or necrosis, which is a surgical emergency. Mild edema can be normal immediately after surgery, but discoloration is not. - Red bloody drainage from the nasogastric tube:
While some light bleeding may occur after gastrointestinal surgery, bright red blood in NG tube drainage is abnormal and could suggest upper GI bleeding or trauma from tube placement. This finding would require prompt evaluation.
Conclusion:
The only expected and non-alarming finding 8 hours post-colostomy is the absence of drainage from the colostomy. The other findings either suggest abnormal complications or are inconsistent with the early postoperative course. Monitoring for the gradual return of bowel function and watching for complications like infection or ischemia is key in postoperative colostomy care.
