A male client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, Nurse Oliver notes that the client’s stoma appears dusky. How should the nurse interpret this finding?
A. Blood supply to the stoma has been interrupted.
B. This is a normal finding 1 day after surgery.
C. The ostomy bag should be adjusted.
D. An intestinal obstruction has occurred.
Correct Answer: A. Blood supply to the stoma has been interrupted
An ileostomy stoma forms as the ileum is brought through the abdominal wall to the surface skin, creating an artificial opening for waste elimination. The stoma should appear cherry red, indicating adequate arterial perfusion. A dusky stoma suggests decreased perfusion, which may result from interruption of the stoma’s blood supply and may lead to tissue damage or necrosis.
Option B: Stoma necrosis or a dusky stoma usually occurs within the first 5 postoperative days. The stoma appears discolored rather than red, moist, and shiny. Discoloration may be cyanotic, black, dark red, dusky bluish-purple, or brown.
Option C: Adjusting the ostomy bag wouldn’t affect stoma color, which depends on blood supply to the area.
Option D: Symptoms of intestinal obstruction may include acute abdominal pain, absence of output or extremely watery output, nausea or vomiting, and a swollen, hard abdomen.