Question

The nurse is caring for a client three days after a bowel resection and colostomy due to acute diverticulitis. Which postoperative assessment finding necessitates physician notification? A. Stoma protrudes above the abdominal wall B. Absence of feces in the colostomy bag C. Gray dusky color of the stoma D. Mucus oozing from the stoma opening

Short answer

Answer: Gray dusky color of the stoma.

Step-by-step solution

Option A: Stoma protrudes above the abdominal wall

A stoma protruding above the abdominal wall is a normal and expected finding. This allows the stoma to drain properly and does not indicate a problem that would require physician notification.

Option B: Absence of feces in the colostomy bag

A lack of feces in the colostomy bag at three days postoperative may or may not be a cause for concern. In the first few days after surgery, it is normal for the output to be minimal, and it may take a few days for bowel function to return to normal. However, it is important to monitor the client closely and report any changes, such as abdominal pain or distention. For this exercise, the absence of feces in the colostomy bag is not considered urgent enough to necessitate physician notification.

Option C: Gray dusky color of the stoma

A healthy stoma should appear pink or red, and a gray or dusky color may indicate poor blood supply to the stoma. This is a cause for concern as it can lead to stoma necrosis or infection. This finding necessitates physician notification.

Option D: Mucus oozing from the stoma opening

It is normal for some mucus to be produced by the lining of the intestines and to be present in the colostomy bag. Mucus oozing from the stoma does not indicate a problem that would require physician notification. Based on the analysis of each option, the correct answer is: C. Gray dusky color of the stoma