A nurse is assessing stoma before changing the colostomy bag. Which one of the following colour of stoma indicates ischemia?

Appeared in: ESIC Nursing Officer-7July 2024

Explanation

A dusky blue or purplish color is the classic sign of stoma ischemia, indicating a compromised or reduced blood supply to the bowel tissue.
This finding is considered a post-operative complication that requires urgent reporting to the surgeon or primary care provider.
Prompt intervention is necessary to restore blood flow and prevent the stoma from progressing to necrosis (tissue death).

Option A: A rose pink color is indicative of a healthy, viable, and well-perfused stoma.
Option B: A brown-black color signifies necrosis, which is tissue death. This is a more severe and advanced condition than ischemia.
Option D: A bright red color, similar to rose pink, indicates a healthy stoma with excellent blood supply.

Visual 1: Infographic - A chart showing images of stomas with different colors (bright red, dusky blue, black) and labeling each with its corresponding condition (Healthy, Ischemic, Necrotic).

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Stoma assessment and identification of complications in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Stoma color assessment is a critical nursing skill. Failure to recognize and report an ischemic stoma can lead to tissue necrosis, requiring additional surgery and increasing patient morbidity.
Always document the stoma's appearance, including color, size, shape, and the condition of the surrounding skin, with each pouch change.
What if? - If the stoma appeared pale pink instead of dusky blue, the nurse should suspect anemia. While this also requires reporting to the provider and monitoring hemoglobin levels, it is not as acutely time-sensitive as ischemia.

How to Approach the Question

First, identify the key term in the question: 'ischemia'. Understand that ischemia means reduced blood flow.
Next, recall the different colors a stoma can present and what each color signifies in terms of tissue perfusion.
Mentally categorize the colors: Healthy (pink/red), Compromised (dusky/blue/purple), and Dead (black/brown).
Match the term 'ischemia' to its corresponding color, which is 'dusky blue'.
Eliminate the options that represent a healthy stoma (rose pink, bright red) and the option that represents a more severe condition, necrosis (brown-black).

Concept Tested & Keywords

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Practise the full ESIC Nursing Officer-7July 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.