Question

When caring for a client with a uterine prolapse who is to have a pessary inserted, which information should the nurse make certain has been checked? a. Number of pregnancies b. Time since menopause c. Allergy to latex d. Use of douches

Short answer

c. Allergy to latex

Step-by-step solution

Understand the Purpose of the Pessary

A pessary is a medical device inserted into the vagina to support areas that may be affected by a uterine prolapse. Key considerations include ensuring the patient's safety and comfort.

Identify Potential Allergic Reactions

Since a pessary is inserted into the body and often made of latex, it is important to check if the patient has any allergies. This ensures the device chosen does not cause an adverse reaction.

Evaluate Each Option

- a. Number of pregnancies: Relevant for understanding the extent of prolapse but not crucial for the selection of a pessary. - b. Time since menopause: Important for hormonal considerations but not specifically for pessary insertion. - c. Allergy to latex: Crucial for avoiding allergic reactions, which could cause pain, swelling, etc. - d. Use of douches: Less relevant though may affect vaginal flora.

Select the Most Critical Information

Among the options, 'c. Allergy to latex' is the most critical information to ensure a safe and effective treatment with a pessary.

Key concepts

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Uterine prolapse occurs when the muscles and ligaments supporting a woman's uterus weaken, causing the uterus to slip down into or protrude out of the vagina. This condition can lead to discomfort, urinary problems, and other health issues.
Common causes include:

• Multiple pregnancies and vaginal births
• Increased age and menopause
• Chronic coughing or straining
• Obesity

A pessary is a device used to manage uterine prolapse by holding the uterus in place. It is often preferred for patients who cannot undergo surgery or wish to avoid it. There are various types and sizes of pessaries, and a healthcare provider selects one based on the patient's specific needs. It is crucial for the nurse to provide a complete explanation and demonstrate how to insert, remove, and clean the pessary to ensure effective use and maintenance.

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Latex allergy is a significant consideration when selecting medical devices like a pessary. Latex, a natural rubber used in many medical products, can cause allergic reactions in some individuals. Symptoms of a latex allergy can range from mild to severe and include:

• Skin irritation
• Hives
• Runny nose or sneezing
• Breathing difficulties
• Anaphylaxis, a life-threatening reaction

Before inserting a latex pessary, healthcare providers must confirm whether the patient has a latex allergy. If the patient is allergic, alternative materials such as silicone or non-latex versions should be chosen to prevent adverse reactions. Educating patients about potential allergens and observing any signs of an allergic reaction post-insertion is essential for their safety and comfort.

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Patient safety must always be a priority in healthcare. Ensuring patient safety involves several steps:
1. **Comprehensive Assessment:** Check for any allergies, especially to latex since many pessaries are made from it. Conduct a thorough review of the patient's medical history and current conditions.
2. **Proper Device Selection:** Choose the right type and size of pessary based on the patient's anatomy, the severity of the prolapse, and any allergies.
3. **Clear Communication:** Educate the patient on how to correctly insert, remove, and clean the pessary. Provide written instructions and demonstrate the process during the initial fitting.
4. **Regular Follow-ups:** Schedule regular check-ups to inspect the pessary, monitor for complications, and address any issues the patient might face.
5. **Hygiene and Infection Control:** Stress the importance of proper hygiene to prevent infections. Counsel the patient on avoiding douches and other potentially harmful vaginal practices while using a pessary.
By taking these steps, healthcare providers can ensure the pessary is used safely and effectively, providing the necessary relief from uterine prolapse while maintaining the patient's overall well-being.