Question

A nurse is assessing a patients stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding?

A. Irrigate the ostomy to clear a possible obstruction.
B. Contact the primary care provider to report this finding.
C. Document that the stoma appears healthy and well perfused.
D. Document a nursing diagnosis of Impaired Skin Integrity.

Answer 1

A stoma with a shiny appearance and bright red color on postoperative day 3 is a normal finding, indicating a healthy and well-perfused stoma that should be documented in the patient's records.

Step-by-step explanation:

A nurse's assessment of a patient's stoma on postoperative day 3 that shows a shiny appearance and a bright red color typically indicates that the stoma is healthy and well perfused. In this scenario, the correct nursing response would be to document that the stoma appears healthy and well perfused. This indicates good blood flow to the area, and it is a normal finding during the early postoperative period. A shiny and bright red stoma is not generally indicative of an obstruction or skin impairment, and unless there are other concerning symptoms such as pain, significant swelling, or drainage, there is no immediate need to contact the primary care provider. Regular monitoring should continue to ensure that the stoma remains healthy.