Pediatrics Question #13

Question

The nurse is caring for a newborn recovering from a bowel resection for Hirschsprung disease. For which reason should the health care provider be notified?

Answers

  1. Stoma bleeds a small amount when the colostomy bag is changed for the first time on post-op day 3 .
    • Rationale:
  2. Stoma has a grayish-appearing color at the edges but is pink in the middle on post-op day 5.
    • Rationale:
  3. Stoma is pinkish red and moist with a slight amount of pink-tinged mucus on post-op day 2.
    • Rationale:
  4. Stoma is slightly swollen with a small amount of non-formed stool in the colostomy bag on post-op day 6.
    • Rationale:

Overview

Explanation

The correct answer is B. A healthy stoma appears red, moist, and shiny with edema for the first few weeks. Stoma necrosis can occur within the first 5 days post op. A grayish appearing stoma is a reportable finding. Light bleeding on day 3 is a normal finding as the stoma will most likely bleed after the first changing. A stoma that is pinkish red and moist with a slight amount of pink-tinged mucous is a normal finding and indicates a healthy stoma. Most children will be NPO for 24-48 hours after stoma placement and it is normal to have non-formed stool around the 6th postoperative day.

Learning Outcomes

Test Taking Tip

Video Rationale