Case study: Ectopic Pregnancy

Ectopic Pregnancy Mrs. Rumplestilkin is a 27-year old woman, with a history of recurrent miscarriages, comes into the emergency room accompanied by her husband. ADMISSION ASSESSMENT: Subjective Data: -Complains of sharp stabbing pain in left lower abdomen and pain in shoulders -Started spotting about an hour ago. -Gravida 1, Para 0 -7 weeks gestation in this pregnancy. - “I feel dizzy and weak.” -Stated “Scared that I am losing the baby.” Objective Data: -Vital Signs – Temperature 97.80 F, Pulse 100, Respirations 26, Blood Pressure 100/62 -Peri pad with moderate amount of dark red bleeding -Pale, skin cool to touch -Abdomen rigid upon palpation Medical History: The client had no history of pelvic inflammatory disease (PID), no prior use of intrauterine contraceptive device (IUD) and no use of fertility drugs. Lab Data: -HCG level was 13.073 IU/L and in five days increased to 25.217. - A transvaginal ultrasound was used for diagnosis. Results: Transvaginal ultrasound showed no intrauterine pregnancy and showed a ruptured fallopian tube and collecting pelvic fluid. This lead to the diagnosis of ruptured left ectopic pregnancy. The right tube appeared normal. There was absence of hemoperitoneum. Critical Thinking Questions: 1. Mrs. R. was diagnosed with a left tubal ectopic pregnancy. In addition to an ectopic pregnancy being in the fallopian tube, where are other locations? 2. What signs and symptoms did Mrs. R. display that represented irritation of the peritoneum? What other disorders have similar symptoms? Treatment and Nursing Care: 3. Since Mrs. R's. fallopian tube ruptured, what would be the most likely treatment? 4. If the tube had not ruptured, what two additional treatment options could have been considered? Explain how they work. a. b. 5. Mrs. R. asks if she can ever get pregnant again? What does the nurse base the response? 6. Mrs. R. asks what caused the baby to implant in the fallopian tube? The nurse would base the response on the most common predisposing factors related to an ectopic pregnancy which are? 7. What discharge instructions would you provide for Mrs. R and her husband? Instruction for Case Study. Please answer just the question ( e.g. Number 1. then answer). (Can you please used Perry (2014). Maternal Child Nursing Care (5th ed.). Philadelphia, PA: Elsevier.) as one of the reference and any other reference you choose. Identification of Main Issues/Problems - Identifies and demonstrates a sophisticated understanding of the main issues/problems in the case study. Analysis and Evaluation of Issues/Problems - Presents an insightful and thorough analysis of all identified issues/problems; includes all necessary calculations. Recommendations on Effective Solutions/Strategies - Supports diagnosis and opinions with strong arguments and well- documented evidence; presents a balanced and critical view; interpretation is both reasonable and objective. Links to Course Readings and Additional Research - Makes appropriate and powerful connections between identified issues/ problems and the strategic concepts studied in the course readings and lectures; supplements case study with relevant and thoughtful research and documents all sources of information. Writing Mechanics and Formatting Guidelines - Demonstrates clarity, conciseness and correctness; formatting is appropriate and writing is free of grammar and spelling errors. Uses APA and citations appropriately; uses 2 or more references