Which information will the nurse include when teaching a patient who has developed a small vesicovaginal fistula 2 weeks into the postpartum period?
a. Take stool softeners to prevent fecal contamination of the vagina.
b. Limit oral fluid intake to minimize the quantity of urinary drainage.
c. Change the perineal pad frequently to prevent perineal skin breakdown.
d. Call the health care provider immediately if urine drains from the vagina.
ANS: C
Because urine will leak from the bladder, the patient should plan to use perineal pads and change them frequently. A high fluid intake is recommended to decrease the risk for urinary tract infections. Drainage of urine from the vagina is expected with vesicovaginal fistulas. Fecal contamination is not a concern with vesicovaginal fistulas.
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