The nurse is caring for a patient who has been diagnosed with a cystocele. The patient is not a surgical candidate. The plan of care includes noninvasive therapies. What may be included in the plan of care? (Select all that apply.)
a. Kegel exercises
b. Insertion of a pessary
c. Hormone therapy
d. Vitamin B12
e. Increase in fluid intake
A, B, C, E
Nonsurgical management includes teaching the woman how to perform Kegel exercises in order to strengthen the pubococcygeal muscles that support the pelvic floor. Lifestyle changes include increasing fluid intake and a high-fiber diet to avoid constipation, avoiding heavy lifting, and maintaining an optimum weight. Hormone therapy may be prescribed. A pessary (a hard rubber or plastic ring) can be fitted into the vagina by the health care provider to provide support to the pelvic structures. The use of vitamin B12 is included in the care and treatment of a cystocele.
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