38-year-old G4, P4 woman presents with complaints of urinary frequency, urgency, and a sensation of feeling as if she is sitting on a ball.

38-year-old G4, P4 woman presents with complaints of urinary frequency, urgency, and a sensation of feeling as if she is sitting on a ball. She states she feels pressure in her lower abdomen and back. She is very healthy and tries to exercise but has limited mobility secondary to discomfort. Her youngest child is 12 months old, and she is considering having another child.

Past Medical History:

· Hypothyroid, constipation

· Psychosocial history is negative.

· Medications: Calcium, Vitamin D

Exam Findings:

· PE is T 98.6 P 82, R 16 , B/P 112/74

· Abdomen soft NT without masses

· Pelvic exam reveals: female external with urethral caruncle

· Vulva is negative; no obvious abnormalities

· Vagina is with scant discharge, atrophic, moderate vaginal vault prolapse

· Cervix is multiparous; negative cervical motion tenderness

· Uterus small, nontender, no masses

· Ovaries nonpalpable

· Rectal negative

· On Valsalva: +grade 2 cystocele

Remember that the case study needs to include a minimum of two evidence-based practice articles to support your work. All papers must conform to the most recent APA standards.

Answer these questions:

1. Subjective: What subjective data do you need to gather from this patient today?

2. Objective: What objective data would you gather for this patient? Explain your expected findings or state specifically what you are looking for.

3. Assessment: Based on these findings

a. What is your assessment of this patient?

§ Include the ICD10 code and your rationale.

4. Plan: Your patient states she does not want any surgical intervention. Provide a detailed plan of care for this patient and consider the primary and secondary prevention needed. Include all of the following in your plan.

1. Diagnostic testing

2. Pharmacologic interventions: including dosage, route, and frequency and non-pharmacologic

3. Education, including health promotion, maintenance, and psychosocial needs

4. Referrals

5. Follow-up, including return to clinic (RTC) with time frame and reason and any labs that are needed for next visit