The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the primary health care provider?
A.
Soft pasty stool is noted in the collection device
B.
There is purple discoloration of the stoma
C.
Stoma is beefy red
D.
There is skin excoriation around the stoma
The Correct answer and Explanation is:
The correct answer is B. There is purple discoloration of the stoma.
Explanation:
In patients with a recent transverse colostomy, monitoring the stoma’s appearance is crucial for assessing its viability. A healthy stoma should typically appear beefy red, indicating good blood supply and circulation. The stoma’s color and overall condition are vital indicators of its health.
Purple discoloration of the stoma is particularly concerning as it suggests compromised blood flow, which could lead to ischemia (lack of blood supply) or necrosis (tissue death). The stoma’s color reflects its perfusion; thus, any deviation from a pink or beefy red appearance requires immediate attention. If blood supply is insufficient, the tissue may begin to die, leading to serious complications, including the potential need for surgical revision.
In contrast, A. Soft pasty stool is noted in the collection device is a normal finding for a transverse colostomy, as this type generally produces more liquid to soft stool due to the location in the digestive tract.
C. Stoma is beefy red indicates proper blood flow and is a healthy sign, warranting no immediate action.
D. There is skin excoriation around the stoma is a concern but does not require immediate notification unless it is severe or leads to significant infection or discomfort. Skin irritation is a common issue that can often be managed with appropriate barrier creams and changes in appliance.
In summary, the presence of purple discoloration signifies a medical emergency requiring prompt notification of the primary health care provider to assess and intervene, preventing serious complications for the client.