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NCLEX · Basic Care and Comfort

A client with a new colostomy is concerned about odor and appliance care. Which statement indicates the client needs more teaching?

Correct answer

'I can apply the skin barrier even if the surrounding skin is moist or weepy' — this is incorrect; the skin must be clean and DRY for the barrier to adhere properly and protect the peristomal skin

  1. A 'I should empty the pouch when it is one-third to one-half full.'
  2. B 'I can apply the skin barrier even if the surrounding skin is moist or weepy' — this is incorrect; the skin must be clean and DRY for the barrier to adhere properly and protect the peristomal skin
  3. C 'I should check the stoma color regularly — it should be pink or red and moist.'
  4. D 'Certain foods like eggs and fish can increase odor.'

Why this is the answer

COLOSTOMY CARE TEACHING: CORRECT statements (no further teaching needed): Empty pouch at 1/3 to 1/2 full (prevents weight pulling appliance off and leakage); Stoma should be PINK/RED and MOIST (healthy perfusion — report pale, dusky, purple, or black stoma immediately = ischemia); Odor management with diet awareness (eggs, fish, garlic, onions increase odor); INCORRECT statement (needs teaching): Applying barrier to moist/weepy skin — the skin MUST be clean and completely DRY for the skin barrier (wafer) to adhere; moisture prevents adhesion and causes leakage and skin breakdown; STOMA ASSESSMENT: Healthy = pink/red, moist, slightly raised; CONCERNING = pale (anemia/poor perfusion), dark/dusky/purple/black (ischemia/necrosis - EMERGENCY); PERISTOMAL SKIN: Should be intact; protect from effluent with proper barrier fit; report excoriation; LPN role: reinforce ostomy teaching, assess stoma, support client adjustment.
Source: NCLEX-PN Physiological — Basic Care, Colostomy Teaching

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