The nurse is caring for a 44-year-old married woman who is ...

[armygirl]

The nurse is caring for a 44-year-old married woman who is complaining of painful intercourse and incontinence due to prolapse of reproductive organs. Clinical evaluation reveals that the patient has a cystocele.
 
  Which treatment option is most appropriate for this patient?
  a. Pelvic floor training
  b. Vaginal pessaries
  c. Surgical correction
  d. Lifestyle changes

Question 2

In order to fully assess the patient and plan appropriate care including health teaching regarding sexuality the nurse should realize that which patient is most at risk for sexual abuse?
 
  a. A recently divorced 50-year-old woman
  b. A Hispanic teenage girl
  c. A 30-year-old African-American male
  d. An individual with intellectual or developmental disabilities

[jaaaaaaa]

Answer to Question 1

ANS: C
Depending on the cause, a cystocele can be readily corrected by surgery. Pelvic muscle floor training (Kegel exercises) will most definitely help with symptoms of urinary incontinence. This alone is not adequate treatment for this patient. Vaginal pessaries are an excellent treatment modality for uterine prolapse. Lifestyle changes such as weight loss, avoiding constipation, and reducing high-impact exercise, such as running, will all help the patient with pelvic organ prolapse. Although these modalities will provide relief, they will not correct the cystocele without surgical intervention.

Answer to Question 2

ANS: D
As more of these individuals move into mainstream society, it is important that sexual health is promoted, including teaching regarding sexual norms. Otherwise these individuals are likely victims of unhealthy sexual practices or sexual abuse. In today's society, the newly unpartnered are likely to begin dating and acquire one or more new sexual partners. This group is at significant risk for exposure to sexually transmitted infections and requires health teaching related to safer sexual practices. The Hispanic teenage girl is at increased risk for unintended teen pregnancy. Adolescent pregnancy puts an undue burden on the young woman during a crucial period of growth and development. Hispanic teens experience double the rate of pregnancy of Caucasian adolescents. Major health disparities continue to exist between African-Americans and their Caucasian counterpartsin particular a significantly increased risk for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and other sexually transmitted diseases.

[armygirl]

Excellent

[tranoy]

TYSM