05/09/2026
π©Ί STOMA ASSESSMENT: NORMAL VS. ABNORMAL FINDINGS
When assessing a stoma, donβt just look at the pouch. Assess the color, moisture, appearance, bleeding, output, surrounding skin, and associated symptoms.
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COLOR β NORMAL:
A healthy stoma should be red to bright pink, showing good blood flow.
π¨ ABNORMAL:
A stoma that appears pale, dusky, gray, blue, purple, or black may indicate impaired circulation or ischemia and requires prompt evaluation.
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APPEARANCE β NORMAL:
The stoma should be moist, shiny, and soft in appearance. Mild swelling can be expected shortly after surgery. Depending on the type of ostomy, the stoma may protrude above the skin or sit relatively flush.
π¨ ABNORMAL:
Watch for a stoma that becomes dry, significantly swollen, retracted below skin level, separated from the surrounding skin, or excessively protruding, which may indicate complications such as retraction or prolapse.
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BLEEDING β NORMAL:
Because stoma tissue is highly vascular, a small amount of bleeding with gentle cleansing or minor contact may occur.
π¨ ABNORMAL:
Persistent, spontaneous, or heavy bleeding should be reported and evaluated.
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OUTPUT β NORMAL:
Expected output depends on whether the patient has an ileostomy or colostomy. Some mucus may also be normal depending on the type of ostomy.
π¨ ABNORMAL:
A sudden change in output, little or no output accompanied by abdominal cramping, distention, nausea, or vomiting may indicate obstruction or another complication.
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PERISTOMAL SKIN β NORMAL:
The skin surrounding the stoma should be clean, dry, and intact.
π¨ ABNORMAL:
Report increasing redness, warmth, swelling, ulceration, skin breakdown, or purulent drainage.
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PAIN β NORMAL:
The stoma itself does not have normal pain sensation.
π¨ ABNORMAL:
New abdominal pain, cramping, or tenderness around the stoma, especially when accompanied by discoloration, swelling, or decreased output, requires further assessment.
π‘ NURSING TIP:
A dusky, blue, purple, gray, or black stoma is never a finding to ignore. Think impaired perfusion and act promptly.