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, scarring
2) Tubal surgery
3) IUD

Question 3

Ectopic pregnancy: s/s (5)

Answer 3

1) Stabbing pain
2) Delayed 1-2 weeks, light or irregular menses
3) Scant, dark read or brown spotting, bright red if tubal rupture
4) REFERRED SHOULDER PAIN
5) light headed, s/s of hemorrhage shock: hypotension, tachycardia, pallor

Question 4

Ectopic pregnancy: Labs (2)

1) tube intact
2) tube ruptured

Answer 4

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

Question 5

Ectopic pregnancy: Diagnostics/Therapeutic Procedure TX

1) Empty uterus
2) To salvage fallopian if not ruptured
3) Removal of ruptured tube
4) If rupture has not occurred and tube preservation is desired

Answer 5

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

Question 6

Ectopic pregnancy: Nursing actions (5)

Answer 6

1) Replace fluids and maintain electrolyte balance
2) Pt ed and support
3) Admin meds
4) prepare client for surgery and post-op care
5) Referral for client and partner to support group

Question 7

Ectopic pregnancy: Nursing considerations

Answer 7

1) hCG and progesterone levels
2) liver and renal studies
3) CBC, type and Rh

Question 8

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

Answer 8

Methotraxate

avoid alcohol, folic acid, sun