Ectopic Pregnancy
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| Ectopic Pregnancy Definition | Implantation of the ovum in any other site other than endometrial lining of the uterus. May be seen OP, might need IP treatment, emotional support
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| Most common site is________ , hence often called_______, , but it can occur in__________ . | fallopian tube, tubal pregnancy, a variety of locations
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| Risk factors | PID (causes tubal damage) *
previous tubal surgery
* endometriosis
* DES exposure
* presence of IUD
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| May show normal pregnancy signs initially and_______ | hCG is present.
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| Signs/symptoms: | Sharp one sided pain, referred shoulder pain, lower abdominal pain, adexal tenderness (area of abdomen over each ovary and fallopian tube)
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| Signs/Symptoms: | pregnancy may be palpable, may progress to rigid abdomen, internal bleeding if there is a rupture.
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| Labs | hCG may be present but does not rise as it would in a normal pregnancy (doubling every 48-72 hours)
Serum progesterone levels – less than 5ng/ml (25 ng/ml or higher is normal)
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| Labs Progesterone level <5 ng/mL indicates_____ | a dead fetus
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| Teatment for ectopic pregnancy can be either______ or ________ | medical or surgical
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| Medical treatment for a woman who desires futures pregnancy is________ | methotrexate given IM
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| Methotrexate causes _________ and the patient must avoid_____ _____________ | photosensitivity, sun exposure
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| Methotrexate is a_____________ | folic acid antagonist that interferes with DNA synthesis
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| Surgical treatment for a woman who desires futures pregnancy is________ | salpingostomy via a laparoscope
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| If the tube is ruptured or future childbearing is not an issue, then ___________ is performed, leaving the ______if it is not damaged. | salpingectomy (removal of the tube), ovary
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| With both medical and surgical therapies for ectopic pregnancy, the __________________woman is given RhoGAM to prevent sensitization | Rh-nonsensitized
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| Assessment | amount of vaginal bleeding, VS for developing shock
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| Possible nursing diagnoses? | Fear, Pain, Anticipatory grieving
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| Evaluation | Woman can explain ectopic pregnancy, treatment options, grieving process
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| Following evacuation of the mole, the nurse must monitor____ and _____ for evidence of a ______ | VS, bleeding, hemorrhage
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| ________ is administered keep uterus contracted and to prevent hemorrhage | Oxytocin
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| The nurse must emphasize the importance of _______ _________ | follow-up care
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