It is anticipated that the initial discussion post should be in the range of 250
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Case Study:
An 83-year-old woman complains of a dragging sensation in the lower abdomen and lower back pain when standing or walking. It has been present for some years but she can now only stand for a short time before feeling uncomfortable. It is not noticeable at night. She has had four vaginal deliveries. She had her menopause at 52 years and took hormone replacement therapy for several years for vasomotor symptoms. She has not had any postmenopausal bleeding and has not had a pap smear for several years.
She is generally constipated and sometimes finds she can only defecate by placing her fingers into the vagina and compressing a “bulge” she can feel. She has mild frequency and gets up twice most nights to pass urine. There is not dysuria or hematuria. Occasionally she does not get to the toilet in time and leaks a small amount of urine, but this does not worry her unduly.
Medically she is very well and does not take any medications regularly. She lives alone and does her own shopping and housework
Examination – on exam she appears well. Blood pressure and heart rate are normal. She is of average build. The abdomen is soft and non-tender. There is a loss of vulval anatomy consistent with atrophic changes. On examination in the supine position there is a mild prolapse. On standing, the cervix is felt at the level of the introitus. There is a large posterior wall prolapse and a minimal anterior wall prolapse.
Questions:
What is the diagnosis for her discomfort and pain?
How would you manage this patient?
Please be sure to validate your opinions and ideas with citations and references in APA format.