Ectopic Pregnancy for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Ectopic Pregnancy for Certified Emergency Nursing (CEN)
Outline
Ectopic Pregnancy
Definition/Etiology:
- Embryo implants at a site other than endometrium of uterus
- Typically, in fallopian tube, will eventually rupture
- Usually appears in 6th week of gestation
- 2% of all pregnancies in the U.S.
Clinical Presentation:
- Late or irregular period; abnormal vaginal bleeding
- Sudden onset of severe, unilateral pelvic pain
- Abdominal tenderness, guarding
- Palpable pelvic mass
- Positive pregnancy test
- Nausea, vomiting
- Rupture – Shoulder pain (Kehr sign), signs of shock, decreasing level of consciousness
Collaborative Management:
Assessment-
- hCG positive
- Progesterone level above 25 ng/mL
- CBC, Type and crossmatch with Rh
- transabdominal or transvaginal ultrasound
Interventions-
- IV fluids
- RhoGAM if Rh negative
- Prepare for surgery if suspected rupture
- Methotrexate (IM)
Evaluation | Patient Monitoring | Education:
Methotrexate (IM)-
- Must be stable with no signs of bleeding
- Must be reliable, compliant, able to return for follow-up
- Methotrexate is cytotoxic and should not be handled by pregnant nurses or those of childbearing age
- Personal protective equipment, including chemotherapy gloves, are worn by anyone handling methotrexate
- Methotrexate interferes with DNA synthesis and disrupts cell multiplication
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
- Savone, D. (2017). Genitourinary, Gynecology, and Obstetrical Emergencies. In CEN Online Review. Emergency Nurses Association.