maternal and newborn

Question 1

Ectopic pregnancy

Answer 1

is an abnormal and non-viable
pregnancy that occurs when a fertilized ovum implants
outside of the uterus, most commonly in the fallopian
tube

Question 2

Ectopic pregnancy:

Answer 2

If the client has missed menses, spotting, and unilateral abdominal pain, assess for
ectopic pregnancy, and if confirmed, administer methotrexate. Do not take folic acid supplements, as
these interfere with methotrexate’s effects. or prepare for emergent surgery.

Question 3

If the fallopian tube ruptures,

Answer 3

internal bleeding
can occur, causing:
Sudden, sharpin abdominal pain
Referred shoulder pain caused by blood in the
peritoneal cavity
Cullen sign (ecchymotic blue abdomen) caused
by internal bleeding
Signs of shock (increased HR, low BP)

Question 4

methotrexate: after giving med

Answer 4

To ensure pregnancy was fully dissolved,
monitor human chorionic gonadotropin (β-hCG)
levels frequently (e.g., weekly for 7 weeks) until
undetectable.
Serial β-hCG measurements help indicate
pregnancy progression or loss.
Comfort client and refer to support groups for
pregnancy loss.

Question 5

Monitor for rupture:
If a client experiences shoulder pain or sudden
increased abdominal pain, suspect a ruptured
ectopic pregnancy.

Answer 5

Avoid analgesics stronger than acetaminophen,
like opioids, to avoid masking symptoms
of rupture.
For a ruptured fallopian tube, the #1 priority =
control bleeding and prevent hypovolemic shock:
Prepare the client for emergent surgery to
repair rupture.
Monitor VS frequently (every 15 min) to
assess for shock (HR,BP).
Obtain a CBC to evaluate blood loss.
Determine client’s blood type and Rh status.
Insert two large-bore VADs for volume
replacement:
IV fluids
Blood transfusion

Question 6

emergent surgery

Answer 6

Salpingectomy: Removes whole fallopian
tube when ruptured
Salpingostomy: Removes products of
conception, preserving the unruptured
fallopian tube

Question 7

Ectopic pregnancy teaching:

Answer 7

For ectopic
pregnancies, teach clients that frequent β-hCG
monitoring is needed to confirm pregnancy
termination. Avoid sexual intercourse until β-hCG
is undetectable, and use contraceptives for
≥3 menstrual cycles.

Question 8

Molar pregnancy:
Prepare client for vacuum aspiration and
curettage to remove pregnancy tissue. Molar pregnancies increased risk for hemorrhage.

Answer 8

If the client has dark brown
vaginal bleeding with grape-like clusters and
fundal height greater than expected, suspect
a molar pregnancy and prepare client for
evacuation of the uterus.
Hyperemesis (excessive nausea and vomiting)
caused by high β-hCG levels
Preeclampsia occurring <24 weeks gestation

Question 9

Molar pregnancy teaching:

Answer 9

After removal of
molar pregnancy, monitor β-hCG levels for up
to 1 year to assess for malignancy. Teach client
to avoid pregnancy until malignancy is ruled out
and to not use an intrauterine device (IUD) for
contraception. Use oral contraceptives.