Ectopic Pregnancy Nursing Care Management

 Description

• Implantation of products of conception in a site other than the uterine cavity (e.g., fallopian tube, ovary, cervix, or peritoneal cavity.)

Etiology

• Ectopic pregnancy can result from conditions that hinder ovum passage through the fallopian tube and into the uterine cavity, such as:
  1. Salpingitis
  2. Diverticula
  3. Tumors
  4. Adhesions from previous surgery
  5. Transmission of the ovum from one ovary to the opposite fallopian tube.

Pathophysiology

• The uterus is the only organ capable of containing and sustaining a pregnancy. When the fertilized ovum implants in other locations the body is unable to maintain the pregnancy.

Assessment Findings

1. Associated findings

• Suspect ectopic pregnancy in a client whose history includes a missed menstrual period, spotting, or bleeding pelvic or shoulder pain, use of intrauterine device, pelvic infections, tubal surgery, or previous ectopic pregnancy.
• Be aware of grief and lost manifestations in the client and family.

2. Common clinical manifestations. (The client with ectopic pregnancy may report signs and symptoms of a normal pregnancy or may have no symptoms at all.)

• Dizziness and syncope (faintness)
• Sharp abdominal pain and referred shoulder pain
• Vaginal bleeding
• Adnexal mass and tenderness
• A ruptured fallopian tube can produce life –threatening complications, such as hemorrhage, shock, and peritonitis.

3. Laboratory and diagnostic study findings

• Blood samples for hemoglobin value, blood type, and group, and crossmatch.
• A pregnancy test reveals elevated serum quantitative beta hCG.
• Ultrasound will confirm extrauterine pregnancy.