Ch. 5 - Abortion Flashcards
Purposeful interruption of pregnancy before 20 weeks of gestation
Contributing factors
Legal and moral issues (Roe v. Wade 1973)
Association of Women’s Health and Neonatal Nurses (AWHONN) supports a nurse’s right to choose to participate in abortion procedures in keeping with his/her beliefs - professional organization for nurses; consciouensis objector; protect nurses rights
Abortion
Elective: requested; purposeful; entire first trimester into second trimester
Therapeutic: for reasons of fetal or maternal health; purposeful; entire first trimester into second trimester
Spontaneous abortion - not purposeful
Purposeful interruption of pregnancy before 20 weeks of gestation
Preservation of the life of the mother - mom’s health in question
Genetic disorders of the fetus - fetus not live outside body
Rape or incest
Pregnant woman’s request
Contributing factors
First-trimester abortion
Second-trimester abortion
Care management: abortion
Conception to 12-13 week
Induced abortion performed in the first trimester is safest and less complex
Surgical (aspiration) abortion
Medical abortion
First-trimester abortion
Most common procedure
Ideally 8-12 weeks from last menstrual period
Bimanual exam done before exam to examine uterine size and position, speculum inserted with local anesthetic and cervix dilated and cannula connected to suction the uterine cavity and products conception evacuted from uterus
Surgical (aspiration) abortion
Methotrexate (oral or IM)and misoprostol (follows 3-7 days after methotrexate and placed vaginally)
Mifepristone (can be taken up to 7 weeks from last menstruation) and misoprostol (taken orally 48 after mifepristone) - induction agent for pregnancy in full-term and also induce abortion in first trimester
Medications
Medical abortion
Dilation and evacuation
Cervical preparation with prostaglandins - laminara
Emotional considerations - nurses role: be there for mom
Second-trimester abortion
Typically performed 13-16 weeks gestation
Fetus larger than 8 weeks - twice size; dilate cervix to allow passage of products of conception
Dilation and evacuation
Calm matter of fact approach by nurse extremely helpful; clarifying, restating, reflecting statements and open-ended questions, nonjudgement; partner, fam involved - need support; victim human trafficing = larger social issue to consider; if fam and friends cannot be involved, schedule time for nursing personnel to give support essential part of care plan
Also about other options - adoption
Abortion in second trimester more emotional distress than in first-trimester: not first pregnancy and have living children and feel baby move: made decision to abort and not feel movement, lot deal with; consider the mom and everybody who needs support
Guilt
Anxiety
Emotional distress typically greater in second-trimester abortions
Thorough counseling about alternatives
Emotional considerations - nurses role: be there for mom
Common complications:
Nursing education on complications should focus on informing women to report after abortion:
Care management: abortion complications
Infection - inflate cervix - anything invasive; IV
Retained products of conception - all products not evacuated
Prolonged, Excessive vaginal bleeding
Common complications:
Fever greater than 100.4
Chills
Bleeding more than one peripad/hour or heavy bleeding for >3 days
Foul-smelling vaginal discharge - infection
Severe abdominal pain, cramping or backache
Abdominal tenderness with applied pressure
Indicate infection inside: d/c teaching
Nursing education on complications should focus on informing women to report after abortion:
