Editing Fundamentals of Nursing – RN Practice Questions (section)

==Question 12==
A patient with a new ileostomy is being evaluated by the nurse. Which finding requires immediate provider notification?
# The stoma is beadlike, moist, and pink to red.
# The pouch contains 400 milliliters of liquid to pasty effluent over eight hours.
# The stoma appears dusky purple with no visible bleeding when touched.
# The patient reports feeling embarrassed and does not want to look at the stoma.

'''Answer:''' 3. The stoma appears dusky purple with no visible bleeding when touched.

''Rationale:'' A healthy stoma is pink to red, moist, and slightly raised, and it bleeds slightly with cleansing because it is vascular mucosa. A dusky, purple, or black stoma indicates ischemia and possible necrosis, which is a surgical emergency and must be reported immediately. Option 1 describes a normal stoma. Option 2 describes expected ileostomy output, which is liquid to pasty; the nurse monitors for dehydration and electrolyte loss but this is not an emergency. Option 4 is a common and expected psychosocial response requiring support and gradual education, not urgent notification.