ASSIGNMENT : RH HNUB325

UNIT : HNUB322 RESEARCH

STUDENT ADMIN NO:HB12/PU/23670/16
YEAR OF STUDY : 3
LECTURER : E.MAKOKHA

PREPARED BY: RAEL AKINYI LUMUMBA

Questions:

1. Watch the video “Why did Mrs. X die” and discuss the factors that led to her
death and how they could have been avoided.

2. Describe the reproductive problems of the elderly.

ANSWERS
1. FACTORS THAT LED TO MRS X DEATH
I am going to discuss some of the factors that led to Mrs x demise.
First and foremost, Mrs X had a history of bleeding in pregnancy and had attended antenatal
clinic only once. As a result of poverty she could not afford transport to clinic.In addition
illiteracy was a factor, she had been not sensitized on the importance of ANC visit and the fact
that she was burdened in taking care of the family and house chores alone since the husband was
not assisting in extraneous work like carrying water from a distance river, was a clear evidence
of Gender based violence.
Moreover, Mrs X was unhealthy due to poor nutrition since she would serve the husband, her
boys and girls then finally herself this made her eat little food. In her community, men and boys
would be served first then the female lastly regardless of their nutrition demands.
Secondly, Mrs X was diagnosed with placenta Previa and severe Anaemia when she arrived to
the hospital after 6 hours drive but the hospital had poor emergency response procedures which
also contributed to her death. For instance, the hospital was to transfuse blood to Mrs X but she
only got half a unit. In addition, Mrs X lacked required medication and got a caesarean section 3
hours later due to limited resources. If only she could have been attended to early enough then
the progress could have been healthy.

HOW THE FACTORS COULD BE AVOIDED

It is evidenced that Mrs X was not ready to get pregnant but due to unmet needs she could not
avoid to be gravid.
if only the hospital could have organized for monthly outreach to serve and educate the
community on the importance of early ANC visits, danger signs in pregnancy, delivery by skilled
birth attendant, the importance of family planning and nutrition especially to the pregnant
mothers and children under 5 years then maternal mortality rate would have decreased.
The hospital fraternity could have organized a clear hospital emergency services through a
documented standard operational procedure, ensure hospital commodities are well stocked and
referral system improved.
In addition, the hospital could have organized for midwives’ recruitment and enrol them for
customer care training to improve their communication towards patients and clients and clear
this misconception about the maternity staffs since Mrs X community believed that midwives
were harsh and received bribe from patients.
Furthermore, the hospital could have organized an effective linkage referral system between the
community and the facility through community health promoters. The hospital could have
organized with Gender based violence board to address related issues since Mrs X community
had a gap in this sector in terms of knowledge also advocate for human rights since Mrs X died
due to social injustice.
3.Describe the reproductive problems of the elderly.
IN WOMEN
1) Ovarian production of oestrogen and progesterone declines with menopause, changes that
occur in female reproductive system include:
2) Thinning of the vaginal wall
3) Shortening of vagina and a loss of elasticity
4) Decrease vaginal secretions resulting in vaginal dryness itching and decrease acidity
5) Involution of the uterus {atrophy} and ovaries
6) Decrease pub coccygeal muscle tone, resulting in a relaxed vaginal and perineum
IN MEN
1) Testes become less firm but continue to produce viable sperm up to 90 years.
2) Approximately 50years production of testosterone begins to diminish {Tabloski 2009}
3) Decreased libido and erectile dysfunction but not related much with age-related changes
rather with other factors for instance, cardiovascular, neurological disorders, diabetes.
BOTH MEN AND WOMEN
It may take longer to become sexually aroused, longer to complete intercourse and longer before
sexual aroused can occur again.
GENITO URINARY SYSTEM
Kidney mass is decreased, primarily because of a loss of nephrons{Tabloski2009} changes
commonly seen include a decreased filtration rate, diminished tubular function with less
efficiency in resorbing and concentrating the urine genito urinary disorders are more common in
older adults than in the general population. In United States almost 50% of women 80years of
age and older suffer from urinary incontinence {Weber and Kelly,2010}.
It is costly and often embarrassing. It should be evaluated because in most cases it is reversible
or can be treated.
Benign prostatic hyperplasia {enlarged prostate gland} causes a gradual increase in urine
retention and overflow incontinence.
Changes in the urinary tract increase the susceptibility to urinary tract infections. Adequate
consumption of fluids is an important nursing interaction that reduces the risk of bladder
infections and also helps decrease urinary incontinence.

References {Weber and Kelly,2010}, {Tabloski2009}