Practice Quiz

CRNE Exam Prep

Category - Changes in Health

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A nurse is caring for a client 24 hours after an ostomy has been created for the treatment of ulcerative colitis. The nurse determines that the following actions are appropriate except:
  1. Administer Demerol 50 mg IM
  2. Place petrolatum gauze over the stoma
  3. Irrigate the colostomy
  4. Notify the physician with the occurrence of purple-black stoma
Explanation
Answer: C -A colostomy begins to function between three and six days after the surgery; therefore, colostomy irrigation is not appropriate at this time. Irrigation stimulates bowel emptying. Administration of pain medications and application of petrolatum gauze over the stoma are appropriate nursing actions. A pink to red and moist stoma indicates good circulation, whereas, a dusky, purplish stoma indicates inadequate blood supply to the stoma. A brown to black and dry stoma is indicative of necrosis.
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