The nurse is teaching a client about their newly established colostomy. Which of the following statements by the client would require follow-up?
The nurse is teaching a client about their newly established colostomy. Which of the following statements by the client would require follow-up?
A. "I will call my primary healthcare provider (PHCP) immediately if my stoma becomes bluish."
[5%]
B. "I should slowly introduce high-fiber foods in my diet.”
[18%]
C. "I must always wear a pouch over my stoma."
[2%]
D. "I should clean the skin around my stoma with rubbing alcohol."
[75%]
Statistics
Subject/Lesson
Subject
Adult Health
Lesson
Gastrointestinal
Client Need
Test Plan
Basic Care and Comfort
Related Topic
Elimination
Item Type
Item Type
Application
Explanation
Choice D is correct. Skincare is an essential part of teaching a client with a colostomy. The client should not use abrasive products such as rubbing alcohol on the peristomal skin because it may cause damage and lead to poor adherence of the appliance (specifically, the wafer) to the skin. Mild (not moisturizing soap) should be used on the peristomal skin.
Choice A is incorrect. Bluish discoloration of the stoma indicates necrosis and requires immediate action. The client needs to call the PHCP when this happens. The color of a normal, healthy stoma should be reddish to pink.
Choice B is incorrect. The client can return to a regular diet once discharged and introduce high-fiber foods slowly because gas and cramping are a concern if too much fiber is consumed at once.
Choice C is incorrect. A colostomy pouch should be worn over the stoma to collect the feces that is coming out of the stoma.
Related Videos
2 Key Topics
Care of Ostomies
9.5 Elimination & Urinary Management
Additional Info
✓ Assess the client's psychosocial readiness for performing self-care prior to education.
✓ After a colostomy is established, it usually begins to produce stool within two to three days following surgery.
✓ The stoma should be reddish-pink and moist.
✓ The appliance (device) should be changed every three to seven days.
✓ The pouch should be emptied when it is one-third to one-half full.
✓ Skin care is essential, and the peristomal skin should be inspected frequently for breakdown. The surrounding skin should be cleaned with mild soap and water. Then, it should be patted dry. Stoma powder or paste may be used on clean skin to promote adherence with the wafer.
