Antepartum: Maternal Hemorrhagic Causes & Disorders/1st Trimester: ECTOPIC PREGNANCY

Question 1

T or F Ectopic pregnancy is the second most frequent cause of bleeding in early pregnancy and a leading cause of infertility

Answer 1

True(ATI 68)

Question 2

Ectopic pregnancy: Risk Factors (3)

Answer 2

1) Compromised tubal patency , STI, scarring2) Tubal surgery3) IUD

Question 3

Ectopic pregnancy: s/s (5)

Answer 3

1) Stabbing pain2) Delayed 1-2 weeks, light or irregular menses3) Scant, dark read or brown spotting, bright red if tubal rupture4) REFERRED SHOULDER PAIN5) light headed, s/s of hemorrhage shock: hypotension, tachycardia, pallor

Question 4

Ectopic pregnancy: Labs (2) 1) tube intact2) tube ruptured

Answer 4

1) serum progesterone and hCG ELEVATED rules out ectopic pregnancy2) H &H, clotting factors (monitor for DIC, WBC)

Question 5

Ectopic pregnancy: Diagnostics/Therapeutic Procedure TX1) Empty uterus2) To salvage fallopian if not ruptured3) Removal of ruptured tube4) If rupture has not occurred and tube preservation is desired

Answer 5

1) Transvaginal ultrasound showing empty uterus2) Salpingostomy: to salvage fallopian if not ruptured3) Laparoscopic salpingectomy (removal of ruptured tube)4) Methotrexate

Question 6

Ectopic pregnancy: Nursing actions (5)

Answer 6

1) Replace fluids and maintain electrolyte balance2) Pt ed and support3) Admin meds4) prepare client for surgery and post-op care5) Referral for client and partner to support group

Question 7

Ectopic pregnancy: Nursing considerations

Answer 7

1) hCG and progesterone levels2) liver and renal studies3) CBC, type and Rh

Question 8

Ectopic pregnancy: Health promotion and Disease Prevention (Methotraxate) (3)

Answer 8

Methotraxateavoid alcohol, folic acid, sun