Ectopic Pregnancy for Certified Emergency Nursing (CEN)

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Study Tools For Ectopic Pregnancy for Certified Emergency Nursing (CEN)

Example Care Plan_Ectopic Pregnancy (Cheatsheet)
Ectopic Pregnancy Pathochart (Cheatsheet)
Ectopic Pregnancy Laparascopic View (Image)
Ectopic Pregnancy (Image)
OB, Ectopic Pregnancy, Ectopic, Pregnancy Complications (Image)
Ectopic Pregnancy (Picmonic)
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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

 

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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.

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