The nurse is instructing a client with a new colostomy on its care and notes that the stoma is large and dusky. The most appropriate nursing intervention at this time is to
A) assess the client's reaction to the ostomy site.
B) assist the client to irrigate the colostomy.
C) notify the surgeon immediately.
D) reassure the client that the stoma will decrease in size.

Question

Quizplus · Accepted Answer

The nurse should assess the client's stoma closely. The stoma should be red and moist. If it becomes dark or dusky, the nurse must report this to the surgeon immediately as this probably represents ischemia.

The Nurse Is Instructing a Client with a New Colostomy