Certified Medical-Surgical Registered Nurse questions and answers 2024/2025

Certified Medical-Surgical Registered Nurse questions and answers 2024/2025 - answerChristine Warren, 45 years old, has a long history of ulcerative colitis, and non-surgical treatment no longer relieved her symptoms. She underwent a total proctocolectomy and a permanent ileostomy 12 hours ago. The nurse should contact the physician immediately if Mrs. Warren has which of these findings? 1) The stoma appears pale and dry. 2) The stoma appears red and shiny. 3) There is 200 mL of dark green output from the stoma. 4) There is 50 mL of serosanguinous drainage from the stoma. - answer-1) The stoma appears pale and dry. Rationale: If there is an adequate blood supply to the stoma, the color is pink or red, and the stoma is moist as a result of mucous production. A pale dry color suggests ischemia of the stoma or bowel and must be reported immediately to the physician. With an ileostomy initially after surgery, the output is a loose, dark green liquid that may contain some blood. The ileostomy usually begins to drain within 24 of surgery at more than one liter per day. When changing Mrs. Warren's ileostomy bag, the nurse notices that the peristomal skin is irritated. Which of these actions by the nurse would be appropriate before reapplying the appliance?