Question

2. You are caring for Polly, an 87-year-old female who resides in a local extended care nursing facility. In report, you are informed that Polly is a frail (85 pound), bed-bound, African American female 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. (Learning Objectives 2 and 3)

1. What factors described above contributed to Polly’s development of pelvic organ prolapse?

2. What are the management and nursing interventions related to caring for Polly’s severe uterine prolapse?

3. Why do you think Polly is not a good candidate for a pessary?

Answer 1

1.age- weak pelvic floor muslces,COPD,multiple pregnancies, contribute to facturs leading to prolapse.

2.pelvic floor stregthening exercises - kegels, diapers or urinary devices,avoiding constipation,proper treatment of COPD.

• Avoid constipation by eating high-fiber foods and drinking plenty of fluids
• Avoid bearing down to move your bowels
• Avoid heavy lifting
• Control coughing

3.low patient compliance-Pessaries can fall out if you strain, multiparity.