1. Your client, a 37-year-old G5P5, is being seen for a complaint of urinary incontinence with activity. The provider completes the examination and diagnoses her with “stress incontinence secondary to natural changes following multiple childbirths.” The provider has asked you to educate the client about the diagnosis and to discuss the treatment and management of incontinence.
A. What factors are related to this cause of stress incontinence?
B. What treatment options are available?
C. What psychosocial concerns would you discuss with the client?
2. You are caring for Polly, an 87-year-old woman who resides in a local extended care nursing facility. In report, you are informed that Polly is a frail (85 lb), bed-bound, African-American woman with medical diagnoses of end-stage COPD, insulin dependent diabetes, and crippling arthritis. Polly is a G12P10 and has developed Stage IV uterine prolapse. Due to her complex medical conditions and fragility, Polly is not a surgical candidate for treating her prolapse nor does she have a pessary. Additionally, Polly is incontinent of bowel and bladder.
A. What factors described above contributed to Polly’s development of pelvic organ prolapse?
B. What are the management and nursing interventions related to caring for Polly’s severe uterine prolapse?
C. Why do you think Polly is not a good candidate for a pessary?
