Ectopic Pregnancy Case Study (30 min)
Included In This Lesson
Study Tools For Ectopic Pregnancy Case Study (30 min)
Outline
A 31-year-old female presents to the emergency room with sudden pain radiating from her mid abdomen to her right shoulder. The patient reports that she is also experiencing light vaginal bleeding. Upon questioning the nurse finds out the patient has an IUD and that she missed her last period. The patient is currently sexually active with multiple partners as well.
What is the first test the nurse should do on this patient?
What should the nurse be concerned about at this time?
The nurse starts an IV and draws blood work. The doctor orders morphine 2 mg IV q4h PRN moderate to severe pain, and an abdominal ultrasound. The nurse administers the morphine per orders and prepares the patient for an ultrasound by giving a prescribed IV fluid bolus of 1 L Normal Saline for bladder filling. The UAP assists the patient to provide a urine sample, which is used for a point-of-care HCG urine pregnancy test – which comes back positive. The UAP and patient report to the RN that there was more bleeding when she went to the bathroom and the patient iis complaining of some upper shoulder pain now.
What should the nurse be concerned about at this time?
The nurse notifies the doctor who orders an abdominal ultrasound, which shows a tubal rupture. The patient is rushed to surgery. When the patient returns from surgery, the nurse assesses the patient. Vital signs are stable at this time, the patient is alert and oriented to person, place, time and situation (a little groggy) and the nurse notes no signs or symptoms of distress. While the patient was off the unit, the complete blood count comes back and the hemoglobin is 6.2. The type and screen also result and shows the patient is blood type O and rH factor negative
Why would the patient have a low hemoglobin with only light vaginal bleeding?
What else should the nurse ensure is administered to this patient?
Debrief: A ruptured ectopic pregnancy would cause internal bleeding, as opposed to external (vaginal) bleeding. The patient bleeds into the abdominal cavity as opposed to out through the uterus and vaginal canal. Ectopic pregnancies will start the same as a normal pregnancy with a missed period and then at around 6 weeks, there is spotting and abdominal pain because the cells have grown within the tube and are getting bigger but the tube does not stretch to accommodate this growth. This causes pain and relief in pain in addition to radiating pain to the shoulders signifies internal bleeding from a tubal rupture. The overall goal is to find the ectopic pregnancy and remove it to save the fallopian tube, but this doesn’t always happen.
Rina’s NCLEX Study Plan
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Circulatory System
- Cardiac Disorders
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Basics of NCLEX
- Test Taking Strategies
- Respiratory Disorders
- Hematologic Disorders
- EENT Disorders
- Basics of Chemistry
- Adult
- Medication Administration
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Anxiety Disorders
- Renal Disorders
- Prenatal Concepts
- Vascular Disorders
- Gastrointestinal Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Immunological Disorders
- Sexually Transmitted Infections
- Upper GI Disorders
- Microbiology
- Labor and Delivery
- Communication
- Proteins
- Newborn Care
- Hematologic System
- Urinary Disorders
- Eating Disorders
- Musculoskeletal Disorders
- Bipolar Disorders
- Terminology
- Pregnancy Risks
- Concepts of Population Health
- Factors Influencing Community Health
- Postpartum Complications
- Prioritization
- Psychotic Disorders
- Basics of Human Biology
- Neurologic and Cognitive Disorders
- Labor Complications
- Writing
- Statistics
- Community Health Overview
- Dosage Calculations
- Musculoskeletal Trauma
- Neurological Trauma
- Note Taking
- Cardiovascular Disorders
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Cognitive Disorders
- Depressive Disorders
- Developmental Considerations
- Shock
- Documentation and Communication
- Legal and Ethical Issues
- EENT Disorders
- Fundamentals of Emergency Nursing
- Emotions and Motivation
- Renal and Urinary Disorders
- Digestive System
- Integumentary Disorders
- Intraoperative Nursing
- Fetal Development
- Basics of Mathematics
- Prenatal and Neonatal Growth and Development
- Childhood Growth and Development
- Preoperative Nursing
- Postoperative Nursing
- Neurological Emergencies
- Understanding Society
- Somatoform Disorders
- Reading
- Emergency Care of the Neurological Patient
- Infectious Respiratory Disorder
- Metabolism
- Oncologic Disorders
- Developmental Theories
- Basics of Sociology
- Emergency Care of the Trauma Patient
- Med Term Basic
- Med Term Whole
- Suffixes
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Newborn Complications
- Male Reproductive Disorders
- Adulthood Growth and Development
- Perioperative Nursing Roles
- Concepts of Pharmacology
- Endocrine System
- Postpartum Care
- Trauma-Stress Disorders
- Psychological Disorders
- State of Consciousness
- Shock
- Skeletal System
- Learning Pharmacology
- Hematologic Disorders
- Prefixes
- Delegation
- Tissues and Glands
- Personality Disorders
- Basic
- Musculoskeletal Disorders
- Disorders of Thermoregulation
- Integumentary Important Points
- Reproductive System
- Psychological Emergencies
- Growth & Development
- Intelligence and Language
- Pediatric
- Sensory System