الأربعاء، 29 أغسطس 2018

309-Cystocele

About
Prolapsed bladder through the vaginal canal.
Assess
Urinary frequency, difficulty, urgency; urinary tract infection; stress incontinence
Complications
Bleeding, urinary retention
Post-operative complications- infection, pneumonia, pain, paralytic ileus, constipation, blood clots
Diagnosis
  • Urge incontinence related to prolapsed bladder
  • Stress urinary incontinence related to prolapsed bladder
  • Risk for infection related to impaired urinary elimination
Goals
  • The client will understand pre-, intra-, and post-operative instructions.
  • The client will be free from infection.
  • The client will be able to normally eliminate urine.
Interventions
  • Teach pelvic floor muscle strengthening exercises ( kegel exercises).
  • Initiate teaching for pessaries, as indicated.
  • Prepare for surgery. Teach client what to expect prior to, during, and after procedures. The following interventions apply for surgery.
  • Teach client coughing and deep breathing exercises to minimize risk of pneumonia.
  • Post-operatively, monitor VS every 15 minutes X 2, every 30 Minutes X 2, every 1 hour X 2, than every 4 hours ( may have different guidelines for each clinical agency).
  • Monitor voiding amount and residuals times 2-3 as ordered.
  • Notify physician if unable to void greater than 6 hours after removing indwelling catheter.
  • Provide proper catheter care; monitor for s/s of infection.
  • Initiate early ambulation to minimize risks of complications.
  • Administer medicines ( analgesics, stool softeners, etc.) as ordered.
  • Perform assessments every 4-8 hours to monitor for complications ( circulation, oxygenation, auscultation, etc).
  • Monitor for signs/ symptoms of complications.

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