A nurse is digitally removing stool that is impacted from a patient. The nurse should stop the procedure immediately and take corrective action if the patient's:

A. Stress does not cause bright red stool. Dismissing the symptom as stress could delay identification of potentially serious gastrointestinal bleeding.

B. Minimizing the patient’s concern is inappropriate because bright red stool may indicate active lower gastrointestinal bleeding, such as from hemorrhoids, diverticulosis, or other more serious causes.

C. Investigating the cause of bright red stool promptly is essential. Collecting a stool sample and notifying the charge nurse ensures timely assessment, early detection of bleeding, and appropriate interventions to prevent complications.

D. Recommending a colonoscopy may be necessary in the long-term evaluation of bright red stool, but immediate assessment and diagnostic steps should occur first. Scheduling a colonoscopy without initial evaluation is premature and does not address acute concerns.

The correct answer is Choice A.

Choice A rationale: A pale blue stoma indicates compromised perfusion or necrosis. This is a surgical emergency requiring immediate assessment to prevent tissue death and systemic complications.

Choice B rationale: Continuous drainage may reflect normal output depending on stoma type. It’s not immediately life-threatening and doesn’t require urgent intervention.

Choice C rationale: Fecal contamination is expected with colostomies. While hygiene is important, this does not indicate a critical issue needing priority care.

Choice D rationale: A beefy red, moist stoma is the expected healthy appearance of a functioning colostomy. No intervention is needed.