A nurse is reinforcing teaching for a client who has a new ascending colostomy. Which of the following comments by the client indicates an understanding of the teaching?
A.
I will irrigate the colostomy every day.
B.
I will notify my doctor if the stoma starts to look purple.
C.
I will no longer be able to eat nuts.
D.
I should expect my stool to be formed.
The Correct Answer and Explanation is:
The correct answer is:
B. I will notify my doctor if the stoma starts to look purple.
Explanation:
An ascending colostomy is a type of colostomy where the colostomy is created from the ascending colon, which is located on the right side of the abdomen. This type of colostomy typically produces liquid to semi-liquid stool due to the location in the digestive tract where water absorption is limited. Understanding the management and signs of complications related to a colostomy is crucial for proper care and maintenance.
A. “I will irrigate the colostomy every day.”
Irrigation is generally not recommended for an ascending colostomy. It is more commonly used for colostomies located in the descending or sigmoid colon, where the stool is more formed. In an ascending colostomy, the stool is more liquid, and daily irrigation could lead to complications such as electrolyte imbalances or dehydration. Therefore, this statement indicates a misunderstanding of the appropriate care for an ascending colostomy.
B. “I will notify my doctor if the stoma starts to look purple.”
This statement reflects an understanding of the potential complications of an ascending colostomy. A stoma should be pink or red, indicating adequate blood supply. If the stoma appears purple or dark red, it could suggest compromised blood flow or ischemia, which is a serious condition requiring immediate medical attention. Notifying the doctor about such changes demonstrates awareness of potential issues and the need for prompt intervention.
C. “I will no longer be able to eat nuts.”
This statement is not entirely accurate for an ascending colostomy. While it’s true that certain foods might cause issues for some individuals with colostomies, it is not specifically necessary to avoid nuts unless advised by a healthcare professional based on individual tolerance. Generally, dietary adjustments are personalized, and nuts might be permissible depending on the client’s experience and tolerance.
D. “I should expect my stool to be formed.”
This statement is incorrect for an ascending colostomy. The stool output from an ascending colostomy is typically liquid to semi-liquid due to the minimal absorption of water in this part of the colon. Expecting formed stool is more characteristic of a descending or sigmoid colostomy, where the stool has had more time to solidify.
In summary, understanding the correct signs of complications and the nature of stool output are key aspects of managing an ascending colostomy effectively.