DEFINITION OF ECTOPIC PREGNANCY

Ectopic pregnancy is gestation located outside the uterine cavity. The fertilized ovum implants outside of the uterus, usually in the fallopian tube.

CAUSES OF ECTOPIC PREGNANCY : Ectopic pregnancies are generally caused by some narrowing of the fallopian tube, most often the result of an infection such as Chlamydia. SIGNS AND SYMPTOMS : Slight vaginal bleeding that is usually brown in color. Women often mistake this bleeding for a normal menstrual period.

Pain in the lower abdomen, felt mainly on one side. Severe pelvic pain Shoulder pain caused by blood from a ruptured ectopic pregnancy pressing on the diaphragm, the large muscle that separates the abdominal and chest cavities Faintness or dizziness caused by blood loss Nausea Vomiting Low blood pressure Lower back pain

DIAGNOSIS :

Quantitative hCG Test Pelvic Examination and Ultrasound Laparoscopic Surgery Culdocentesis

NURSING MANAGEMENT : 1. Ensure that appropriate physical needs are addressed and monitor for complications. Assess vital signs, bleeding, and pain. 2. Provide client and family teaching to relieve anxiety. 3. Explain the condition and expected outcome. 4. Describe self-care measures, which depend on the treatment. 5. Address emotional and psychosocial needs.

MEDICAL MANAGEMENT: If an ectopic pregnancy can be diagnosed by a sonogram before the tube has ruptured, it can be treated medically by the oral administration of methotrexate, a folic acid antagonist chemotherapeutic agent, attacks and destroys fast-growing cells because trophoblast and zygote growth is rapid, the drug is drawn to the site of the ectopic pregnancy. Women are treated until a negative hCG titer is achieved. A hysterosalpingogram or sonogram is usually performed after the chemotherapy to assess whether the tube is fully patent. Mifepristone, an abortifacient, is also effective at causing sloughing of the tubal implantation site. The advantage of these therapies is that the tube is left intact, with no surgical scarring that could cause a second ectopic implantation. SURGICAL MANAGEMENT:

ASSESSMENT ssumasakit ang tiyan ko. As

DIAGNOSIS Acute pain related to rupture of

PLANNING After 8 hours of nursing intervention,

INTERVENTION -monitor maternal v/s.

RATIONALE -to determine presence of

EVALUATION After 8 hours of nursing interventions,

verbalized by the client. o-pain scale of 8/10 ( 10 would be the highest) v/s taken as follows: T-36.4C PR-85 bpm RR-22 cpm BP-110/90

the fallopian tube

the clients pain will be relieved or be on a tolerable level. -monitor for presence and amount of vaginal discharge. -monitor increasd pain, abdominal distention and rigidity.

hypotension and tachycardia caused by rupture or hemorrhage -to further assess the present situation indicating hemorrhafe -increased pain and abdominal distention indicates rupture and possible intraabdominal hemorrhage -to determine the amount of blood loss To promote relaxation and may enhance patients coping with limitations

the clients pain is now tolerable from pain scale of 8/10 down to 2/10 or soon to be completely relieved. Goal met.

monitor complete blood count -provide comfort measures like back rubs, deep breathing, instruct in relaxation, or visualization exercises. Provide diversional activities. -administer medications such as analgesics as prescribed by the doctor.

-to maintain acceptable level of pain.