The Client with an Ectopic Pregnancy
The nurse is assessing a multigravida client at 12 weeks' gestation who has been admitted to the emergency department with sharp right-sided abdominal pain and vaginal spotting. Which of the following should the nurse obtain about the client's history? Select all that apply.
1. History of sexually transmitted infections. 2. Number of sexual partners. 3. Last menstrual period. 5. IUD use. 6. Contraceptive use.
On arrival at the emergency department, a client tells the nurse that she suspects that she may be pregnant but has been having a small amount of bleeding and has severe pain in the lower abdomen. The client's blood pressure is 70/50 mm Hg and her pulse rate is 120 bpm. The nurse notifi es the physi- cian immediately because of the possibility of:
Ectopic pregnancy.
A 36-year-old multigravid client is admitted to the hospital with possible ruptured ectopic preg- nancy. When obtaining the client's history, which of the following would be most important to identify as a predisposing factor?
Episodes of pelvic inflammatory disease.
Before surgery to remove an ectopic preg- nancy and the fallopian tube, which of the follow- ing would alert the nurse to the possibility of tubal rupture?
Falling hematocrit and hemoglobin levels.
After surgery to remove a ruptured fallopian tube, a multigravid client receives discharge instructions about potential complications to report to her physician. Which of the following, if stated by the client as a complication, indicates a need for additional teaching?
Headache.
A multigravid client is admitted to the hospital with a diagnosis of ectopic pregnancy. The nurse anticipates that, because the client's fallopian tube has not yet ruptured, which of the following may be ordered?
Methotrexate.
A multigravid client diagnosed with a prob- able ruptured ectopic pregnancy is scheduled for emergency surgery. In addition to monitoring the client's blood pressure before surgery, which of the following would the nurse assess?
Pulse rate.
