The client with a recto-vaginal fistula is at risk of Infection. The intervention, most important in preventive aspect of nursing care is:
A. Administering antibiotics
B. Ensuring adequate rest to enhance healing
C. Monitoring temperature and WBC count
D. Performing perinatal care
Correct Answer: D. Performing perinatal care
Explanation
For a client with a rectovaginal fistula, the most important intervention to prevent infection is:
➡️ Meticulous perineal hygiene after each bowel movement
Why this is essential:
- Stool can easily enter the vagina through the fistula.
- This contamination greatly increases the risk of vaginal and urinary tract infections.
- Frequent, gentle cleansing reduces bacterial load and prevents skin breakdown.
Key components of this intervention include:
- Perineal care after every bowel movement using warm water or sitz bath.
- Front-to-back cleaning to avoid bringing fecal matter toward the vagina/urethra.
- Keeping the area clean, dry, and well-aerated.
- Using barrier creams if prescribed to protect skin.
So, the most important preventive intervention is:
Strict and thorough perineal hygiene after each bowel movement.
Other Options Details
Here are the descriptions of all the options you listed:
A. Administering antibiotics
This involves giving medications that kill or stop the growth of bacteria. Antibiotics are used when an infection is known or suspected, especially in postpartum or postoperative cases. The goal is to control infection, prevent complications, and promote recovery.
B. Ensuring adequate rest to enhance healing
Rest allows the body to recover more efficiently. Adequate sleep and reduced physical activity help the immune system work better, support tissue repair, and reduce fatigue. Rest is an essential part of managing any illness or recovery period.
C. Monitoring temperature and WBC count
This means regularly checking the patient’s body temperature and white blood cell (WBC) levels.
- Temperature helps detect fever, which signals infection.
- WBC count indicates inflammation or infection in the body.
Continuous monitoring helps identify worsening conditions early and guides treatment decisions.
D. Performing perineal care (likely intended as “perineal care”)
Perineal care involves cleaning and maintaining hygiene of the perineal area (around the vagina and anus), especially after childbirth, surgery, or infection. It helps prevent infections, reduces discomfort, promotes healing, and maintains patient comfort. This includes cleaning techniques, using warm water, proper drying, and sometimes applying specific medications.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group