Care Plans for Ectopic Pregnancy Diagnosis and Interventions
Ectopic Pregnancy NCLEX Review and Care Plans
An ectopic pregnancy is a medical condition in which the zygote does not attach to the uterus and resides in the fallopian tubes, cervix, or another part of the female reproductive system.
The nature of the enclosure does not allow the embryo to fully mature and this will eventually lead to death.
In a healthy pregnancy, the fertilized egg attaches to the inner wall of the uterus. Without a timely diagnosis, an ectopic pregnancy poses a major threat to the mother's life.
Signs and Symptoms of Ectopic Pregnancy
50% of patients have all 3 symptoms of the classic triad of ectopic pregnancy, namely:
- Stomach ache
- Amenorrhea
- Vaginal bleeding
Other associated clinical signs and symptoms common in early pregnancy that may be encountered in ectopic pregnancy include:
- Nausea and vomiting
- Breast fullness
- Fatigue
- Severe cramps
- Pain in the shoulder - may indicate inflammation of the peritoneum
- Dizziness or weakness
- Flu-like symptoms
- Syncope
- Painful movements of the fetus (in advanced abdominal pregnancy)
The following are the clinical manifestations requiring urgent surgical treatment, namely:
- Abdominal stiffness
- Involuntary guard duty
- Heavy tenderness
- Evidence of severe low blood pressure (Hypovolemischshock) - orthostatic changes in blood pressure, tachycardia
Causes and risk factors of ectopic pregnancy
Tubalpregnancyectopic pregnancy, in which implantation occurs in the fallopian tubes, is considered the most common type of ectopic pregnancy.
This happens when the fallopian tubes are damaged or malformed. Hormonal imbalances and abnormal zygote development can also play a role in an ectopic pregnancy.
The following have been proven to increase the risk of developing it:
- Previous ectopic pregnancy. Structural scars from previous ectopic pregnancies contribute to future episodes.
- Inflammation or infection. Pelvic inflammatory disease (PID) caused by infections such as chlamydia andgonorrheait changes the normal structures that block the passage of the fertilized egg
- Fertility treatment. Artificially inducing ovulation with injectable gonadotropin therapy is associated with a 4-fold increased risk, suggesting that multiple oocytes and high hormone levels play an important role in ectopic pregnancy.
- Fallopian tube surgery. Changes and scars on the structures contribute to improper implantation of the fertilized egg
- Choice of birth control. The use of progestin-only oral contraceptives or progestin-only implants (IUDs) may put a woman at risk for an ectopic pregnancy.
- Smoking. Studies have shown that the risk of developing an ectopic pregnancy is 1.6 to 3.5 times higher for smokers than for non-smokers.
Complications of ectopic pregnancy
Complications of an ectopic pregnancy can result from an incorrect or late diagnosis or treatment regimen.
If the diagnosis of ectopic pregnancy is not made correctly and quickly, it will lead to rupture, depending on the implantation site, leading to massive bleeding, shock, disseminated intravascular coagulopathy (DIC), and death.
Diagnosis of ectopic pregnancy
- Physical exam - a pelvic exam can show these findings:
- The uterus is slightly soft and enlarged
- Tenderness during movement of the uterus or cervix - indicates inflammation of the peritoneum
- After palpation, an adnexal mass can be assessed. However, this mass is usually difficult to distinguish from the ipsilateral ovary.
- Serum B-HCG Levels - Serum levels of beta-human chorionic gonadotropin (B-HCG) are elevated, but not as much as in a normal pregnancy. This test is necessary to distinguish a normal from an abnormal pregnancy. This is also essential for monitoring the therapeutic effect of the treatment once therapy has started. An elevated serum B-HCG level and the absence of pregnancy in the uterus are highly suggestive of an ectopic pregnancy or miscarriage.
- Progesterone levels - helpful in diagnosis because progesterone:
- It does not depend on the gestational age
- It remains relatively constant during the first trimester of normal and ectopic pregnancy
- Independent and uncorrelated with B-HCG levels
- If initially abnormal, progesterone levels do not return to the reference range
- Ultrasound - is used as the main tool for diagnosing ectopic pregnancy. It involves the use of sound waves in the assessment of intrauterine and abdominal structures.
- Laparoscopy - used as the gold standard in diagnosing ectopic pregnancy for patients who are in pain or hemodynamically unstable.
Treatment of ectopic pregnancy
Treatment of continuous ectopic pregnancy includes medical and surgical therapies, namely:
- Antimetabolite therapy / folic acid antagonist. In antimetabolite therapy, the patient receives one dose or more sessions of chemotherapy by the intramuscular route. The effectiveness of this regimen for trophoblast is well established due to its original indication for use againsthydatidiform moleschoriocarcinoom.
- Salpingostomy and salpingectomy. Salpingostomy is the surgical removal of an uninterrupted ectopic pregnancy from the fallopian tube using a laparoscopic technique. Salpingectomy is the surgical resection of an uninterrupted ectopic pregnancy and the affected fallopian tube by laparoscopy.
Medicines.Other medical treatments that support the management of an ectopic pregnancy include:
- Folic acid analogues - used with antimetabolite therapy to limit nephrotoxic and hepatotoxic effects while enabling antitrophoblastic activity.
- Vitamin D - used to correct decreased folic acid levels caused by antimetabolite treatment
- vasopressors– used to reduce bleeding during surgery by acting on alpha1 and beta1 receptors, promoting vasoconstriction
Nursing diagnosis of ectopic pregnancy
Care plan for ectopic pregnancy 1
Nursing Diagnosis:Lack of fluid volumeassociated with active blood loss secondary to ectopic pregnancy, as evidenced by an average blood pressure level of 85/50, physical weakness, decreased urine output, and pale, clammy skin
Desired result:The patient will restore functional body fluid volume and balanced input and output.
| Nursing intervention in ectopic pregnancy | Explanation |
| Assess vital signs, perform a physical exam, and begin daily weight monitoring. | Edema, headache, low blood pressure and pain are associated with the patient's blood loss. Fluid retention may be evident if the patient is inexplicably gaining weight. |
| Start monitoring entrances and exits. | To check the volume of circulating blood. To ensure that the patient has adequate oral hydration or if it is necessary to initiate intravenous hydration therapy. |
| Discuss with the patient and family the need for hospitalization to treat severe bleeding and the need for surgery. | For the treatment of vaginal bleeding and fluid deficiency associated with ectopic pregnancy in an appropriate setting. |
| Prepare the patient for surgery for an ectopic pregnancy. Do not give the patient anything by mouth (NBM orNPO) condition. | Salpingostomy is the surgical removal of an uninterrupted ectopic pregnancy from the fallopian tube using a laparoscopic technique. Salpingectomy is the surgical resection of an uninterrupted ectopic pregnancy and the affected fallopian tube by laparoscopy. Placing the patient on Niets Met De Mond (NBM or NPO) is necessary to prepare the patient for an emergency delivery. |
| Prepare forblood transfusionas needed. | To increase blood volume. |
| Encourage the patient to have a low salt intake. | A salt intake of between 2 and 4 g per day is ideal, as very low salt intake can increase dehydration. |
Care plan for ectopic pregnancy 2
Nursing diagnosis: risk of maternal injury
Desired result: The patient will maintain safety and participate in self-protection measures during treatment.
| Nursing intervention in ectopic pregnancy | Explanation |
| Assess the patient's mental state. | An ectopic pregnancy can cause the patient to be in a bad mood,depression, or a negative emotional state, which exposes her to the risk of harming the mother. |
| Monitor the patient's level of consciousness using the AVPU. Heavy vaginal bleeding may occurhypotensionand a lower level of consciousness. Use of the AVPU scale (i.e., alert, voice, painful stimuli, or unresponsive/unconscious) can help determine the urgency of surgical treatment and an increased risk of maternal injury. | |
| Prepare the patient for surgery to remove an ectopic pregnancy. | Ectopic pregnancy is the leading cause of maternal death during the first trimester due to internal bleeding, so urgent surgery is needed to remove it. |
| Place the patient on complete bed rest if there are signs of severe bleeding. | To reduce pain and protect the patient |
Care plan for ectopic pregnancy 3
Nursing Diagnosis:Acute painassociated with ectopic pregnancy as indicated by a pain score of 10 out of 10, verbalization of abdominal pain, abdominal stiffness, and restlessness
Desired result: The patient will demonstrate pain relief as indicated by a pain score of 0 of 10, stable vital signs, and absence of restlessness.
| Nursing intervention in ectopic pregnancy | Explanation |
| Administer prescription pain medication. | To relieve the symptoms of acute abdominal pain. |
| Assess the patient's vital signs and pain characteristics at least 30 minutes after administering the medication. | To monitor the effectiveness of medical treatment for the relief of abdominal pain. The time to check vital signs may depend on the peak time of the drug administered. |
| Raise the head of the bed and place the patient in the semi-Fowler's position. | To increase oxygen levels by allowing optimal lung expansion. |
| Place the patient in complete bed rest during severe periods of pain. Implement non-drug pain relief methods such as relaxation techniques such as deep breathing exercises, guided imagery, and distractions such as TV or radio. | To provide optimal patient comfort. |
| Prepare the patient for surgery. | Salpingostomy is the surgical removal of an uninterrupted ectopic pregnancy from the fallopian tube using a laparoscopic technique. Salpingectomy is the surgical resection of an uninterrupted ectopic pregnancy and the affected fallopian tube by laparoscopy. |
| After surgery, advise the patient to: Refrain from strenuous activities for several weeks. Support your abdomen when you cough, laugh or move by placing a pillow over your abdominal area Notify your health care team if pain medication is not working | To reduce post-operative pain and allow full recovery and healing. |
Care plan for ectopic pregnancy 4
Risk of bleeding
Nursing diagnosis: risk of bleeding associated with active bleeding secondary to ectopic pregnancy.
Desired results:
- The patient will have a stable fetal heart rate and normal vital signs.
- The patient will have less or no vaginal spotting or bleeding.
- The patient will take precautions to prevent additional bleeding.
| Nursing intervention in ectopic pregnancy | Explanation |
| Review the patient's productive history. | Determining the date of pregnancy and determining whether the place of pregnancy is known can be done by viewing the menstrual history and possibly a previous ultrasound. |
| Assess the mother's vital signs. | Check the patient's heart rate, respiration and blood pressure every 15 minutes; use a pulse oximeter and automatic blood pressure monitor if necessary. This provides basic information about how mothers respond to blood loss. As the heart tries to compensate for the lower blood volume and the respiratory system speeds up gas exchange to better oxygenate the red blood cells, the heart rate and breathing rate will begin to increase with the heavy blood loss. |
| Position the patient so that he is comfortable and help him move if necessary. | Patients should lie flat on the bed to minimize movement, stabilize vital organs and maximize comfort. |
| Watch out for any of the following symptoms: severe abdominal discomfort, vaginal bleeding, severe lower quarter pain, and vaginal bleeding. | Before a rupture occurs, it is important to recognize all the warning signs and symptoms. It would be difficult to detect them at first because most ectopic pregnancies do not show strange signs and symptoms at the time of implantation. |
| Schedule the patient's rest and activity time. | If the threatened miscarriage involves a live fetus and possible bleeding, the patient can refrain from vigorous activity for 24 to 48 hours to stop it. Because blood collects in the vagina, complete bed rest is usually not necessary, even if the vaginal bleeding seems to decrease. When the patient begins to move again, the accumulated vaginal blood will flow out and the bleeding will continue. |
| Monitor input and output. | For monitoring blood volume in the circulatory system. To determine if the patient is receiving adequate oral hydration or if intravenous hydration therapy should be initiated. |
| Prepare the patient for surgery to remove an ectopic pregnancy. Do not place the patient in anything by mouth. | Due to internal bleeding, ectopic pregnancy is the leading cause of maternal death during the first trimester. Therefore, immediate surgical removal is required. Using the laparoscopic method, an ongoing ectopic pregnancy is surgically removed from the fallopian tube with a salpingostomy. Salpingectomy is the surgical removal of the affected fallopian tube and unbroken ectopic pregnancy using laparoscopy. To ensure that the patient is ready for an emergency delivery, nothing should be put in her mouth. |
| Prepare for a blood transfusion if necessary | To increase blood flow. |
| Administer medications as directed and watch for any side effects. | Antiemetics and analgesics can be used to treat symptoms. Other medications may be used to absorb the pregnant tissue and preserve the fallopian tubes. |
| Provide the patient with information on how to prevent future ectopic pregnancies. | Educate the patient about risk factors and lifestyle adjustments that can be made to prevent future ectopic pregnancies. Stop smoking. Pelvic infections and ectopic pregnancy are more common in those who have multiple sexual partners. |
| 11. Examine the patient's vital signs and pain characteristics for at least 30 minutes after administering the medication. | Evaluate the effectiveness of medical treatment for pain relief. The time of monitoring vital signs may be affected by the maximum time of drug administration. |
| 12. Provide anxiety relief education to patients and their families. | Describe the situation and the expected outcome. Early diagnosis and immediate treatment, such as laparotomy to tie off the bleeding vessels and repair or remove the damaged fallopian tube, improves the prognosis for mothers. |
Care plan for ectopic pregnancy 5
AnticipatingTo grieve
Nursing diagnosis: anticipatory grief associated with pregnancy loss secondary to ectopic pregnancy, manifested by agitation, changes in communication patterns, and changes in sleep quality.
Desired results:
- The patient and her partner share their grief over the loss of the pregnancy.
- The patient and her partner will use effective coping mechanisms to overcome the grief.
- The patient will express her desire to move through the identified stages of grief at her own pace.
| Nursing intervention in ectopic pregnancy | Explanation |
| Recognize the signs of grief, such as bewilderment, denial, anger, and despair. | The patient, her partner, or her family can go through a spectrum of emotional responses to a grieving process and its actual and potential effects on life. These stages are variable and the patient's progression changes over time. It is common for excruciating pain to take the place of shock after it begins to subside. While this grieving response is painful, it is crucial that the bereaved feel all of their suffering. Negative coping techniques can emerge from the grieving process when the grief of prenatal loss is avoided. |
| Determine if there is a communication gap, emotional lability, or lack of research. | The first reaction to pregnancy loss is shock. After an abortion, some patients suppress their emotions out of a desire to move on as quickly as possible. |
| Note the lack of interest in life, disturbed sleep, suicidal thoughts and despair. | Weeks, months or even years can pass during a depression. This stage of grief can last a long time and includes feelings of sadness, isolation,loneliness, emptiness, despair and self-reflection. At that moment, the bereaved realize the full significance of their loss. |
| Encourage expressing grief by providing privacy, removing time restrictions, and offering support for individuals of your choosing to visit. | These interventions support the patient and family in expressing their grief and initiating the process of resolving it. Grief is a personal experience and people react to it in different ways. Support can be achieved by respecting patient and family emotions and encouraging expression. |
| Use the stages of grief to guide nursing interventions. | By understanding the typical stages of grief, the nurse can determine whether a family member is experiencing normal or dysfunctional grief. The phases help the nurse better understand the patient's behavior; blaming others, for example, is a common grieving process and is not always intended for the nurse or other caregivers. This allows the nurse to reassure the patient that their feelings are normal without making them seem any less intense. |
| Communicate openly and honestly with the patient's family. | The family's ability to express their grief is the first step in resolving their problems, so presence, empathy, and encouraging open communication are key. The family can also be referred to local organizations or interdisciplinary medical teams if needed. |
| Provide the patient's family with clear, factual information about diagnosis and treatment. | When offering emotional support, be honest with the patient's family and avoid fictitious reassurances. The patient may initially become oblivious to her surroundings and events, and her ability to concentrate may be permanently impaired. The family's frustration and grief can be compounded by their lack of knowledge. |
| Accept expressions of anger and despair. Show compassion for the patient instead of arguing. | The treatment provided to patients after the loss of a pregnancy varies, parents expect caregivers to be sensitive to their needs and empathetic to their pain. They are looking for emotional security. Callousness and indifference, which are often unintentional, can make the already difficult situation of the bereaved even more difficult. Warm words of kindness and touch have the ability to heal for a long time. |
| Whenever possible, help the patient take responsibility by helping them establish care routines, dietary preferences, fun activities, and so on. | Encouraging patient participation reduces feelings of helplessness and gives the patient a sense of control and responsibility. If the fallopian tubes were removed during surgery, the patient who has had an ectopic pregnancy may also have problems with weakened self-esteem and feelings of helplessness. |
| Inform the patient and partner about the benefits of psychotherapy as appropriate. | To overcome their grief and come to terms with their unpleasant feelings and memories, individuals who have recently lost a loved one can benefit from psychotherapy. To manage symptoms of anxiety and depression, therapy can also help patients use techniques that include relaxation, pleasurable activities, and challenging negative beliefs. Clinical experience shows that relationship therapy, interpersonal therapy and cognitive behavioral therapy are effective treatments for this target group. Both grieving parents should be involved in therapy, who should communicate with each other at all times. |
Care plan for ectopic pregnancy
Angst/Spanning
Nursing Diagnosis: Anxiety/fear related to possible death of self or fetus secondary to ectopic pregnancy evidenced by verbalization of specific difficulties with words, increased anxiety, and sympathetic activation
Desired results:
- The patient will talk about her fears for herself, her unborn child and future pregnancies, distinguishing between healthy and harmful fears.
- The patient will verbally convey accurate information about that circumstance.
- The client will demonstrate good resource management and problem solving skills.
- The patient will express or report reduced anxiety and/or anxiety-related behaviors.
| Nursing intervention in ectopic pregnancy | Explanation |
| Observe the patient's or couple's nonverbal and verbal responses. | This reveals the level of anxiety the patient or couple is feeling. Most expectant mothers believe their baby is alive until an ultrasound reveals that their fetus has lost its heartbeat. Concerned that she may never be able to carry a child to term, she may need help accepting the reality of the situation and guidance before embarking on a future pregnancy. |
| Check the fetal heart sounds together with the patient and her partner. | Regardless of how the patient views others, she is most likely under great emotional pressure. The patient can't help but worry that the next time she bleeds, she, the baby, or both will die. It is helpful to hear the fetal heart sounds and make sure they are within a healthy range. It is also helpful to have a support person she can talk to about her concerns for the child and for herself. |
| Inform the patient and her partner of the circumstances. | This reveals details about how each person reacts to the current situation. Ensure that the patient is aware that in the event of an incomplete or threatened abortion, the pregnancy has already been lost and that the operations performed are performed to prevent bleeding and infection, not to terminate the pregnancy. |
| Encourage the patient and partner to share their feelings and concerns at appropriate times. | After an abortion, some patients suppress their emotions out of a desire to move on as quickly as possible. If it helps them cope with anger or grief over the loss of a pregnancy, suppression in this way can be helpful in the short term. However, be careful that the patient does not expose herself to bleeding by denying her memory of her medication at the same time as the event. |
| Be attentive to the patient's problems. | This promotes a sense of authority over the circumstances and allows the patient to create their own solutions. The nurse pays attention to the patient and expresses sympathy for her and her partner's grief. They often regret what could have been, even if the pregnancy was not foreseen or intended. They may experience deeper and longer-lasting grief and suffering than they or other people expect. |
| Define the processes and the meaning of any symptoms for the patient. | Anxiety can be reduced and a sense of control over circumstances can be increased with knowledge. After an abortion, most patients adjust well, especially if they have been given accurate and comprehensive information about what to expect during and after surgery. |
| Provide accurate and truthful answers to patient questions. | It will be easier for the patient to deal with the situation if he is informed. Written material allows for future evaluation, as the patient's anxiety level may make it impossible to process the knowledge. Honest answers help others learn more and can reduce anxiety. |
| Make every effort to involve the patient in the planning and delivery of care. | Anxiety can be reduced if there is something you can do to manage the situation. If the fallopian tubes were removed during surgery, the patient with an ectopic pregnancy may also have problems with low self-esteem and feelings of helplessness. |
More about ectopic pregnancy
- Risk toSap
- Helplessnessassociated with early pregnancy loss
Nursing references
Ackley, BJ, Ladwig, GB, Makić, MB, Martinez-Kratz, MR i Zanotti, M. (2020).Handbook of Nursing Diagnoses: An Evidence-Based Guide to Care Planning. St. Louis, MO: Elsevier.Buy on Amazon
NCLEX Examination for Cystic Fibrosis Care…
Cystic Fibrosis Nursing NCLEX Assessment and Care Plan
Gulanick, M. i Myers, JL (2022).Healthcare plans: diagnoses, interventions and outcomes. St. Louis, MO: Elsevier.Buy on Amazon
Ignatavicius, D.D., Workman, M.L., Rebar, C.R. i Heimgartner, N.M. (2020.).Medical-Surgical Nursing: Concepts of Interprofessional Collaborative Care. St. Louis, MO: Elsevier.Buy on Amazon
Silvestri, LA (2020).Saunders Comprehensive Review for the NCLEX-RN Exam. St. Louis, MO: Elsevier.Buy on Amazon
Exemption:
Follow your guidelines, rules and procedures.
The medical information on this site is for informational purposes only and should not be used or relied upon for diagnostic or treatment purposes.
This information is not intended for nursing education and should not be used as a substitute for professional diagnosis and treatment.
FAQs
What are the nursing diagnosis of ectopic pregnancy? ›
Signs and symptoms of ectopic pregnancy typically include abdominal pain, amenorrhea, and abnormal vaginal bleeding. Shoulder pain, as in Mrs. Blackmore's case, may indicate peritoneal irritation.
What is the best diagnosis for ectopic pregnancy? ›An ectopic pregnancy is usually diagnosed by carrying out a transvaginal ultrasound scan.
Which would be the priority nursing diagnosis for a client with ectopic pregnancy? ›Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy? Question 9 Explanation: For the client with an ectopic pregnancy, lower abdominal pain, usually unilateral, is the primary symptom. Thus, pain is the priority.
What is the plan for ectopic pregnancy? ›- expectant management – your condition is carefully monitored to see whether treatment is necessary.
- medicine – a medicine called methotrexate is used to stop the pregnancy growing.
- surgery – surgery is used to remove the pregnancy, usually along with the affected fallopian tube.
The majority of tubal ectopic pregnancies should be visualised on transvaginal ultrasound. Transvaginal ultrasound has sensitivities of 87.0–99.0% and specificities of 94.0–99.9% for the diagnosis of ectopic pregnancy [4].
What does the diagnosis of ectopic pregnancy only depend on? ›Prompt ultrasound evaluation is key in diagnosing ectopic pregnancy. Equivocal ultrasound results should be combined with quantitative beta subunit of human chorionic gonadotropin levels.
When is an ectopic pregnancy diagnosed? ›An ectopic pregnancy doesn't always cause symptoms and may only be detected during a routine pregnancy scan. If you do have symptoms, they tend to develop between the 4th and 12th week of pregnancy.
Why is an ectopic pregnancy hard to diagnose? ›Ectopic pregnancy diagnosis can be difficult based on symptoms alone because it often causes symptoms that can mimic other, more common, conditions such as gastroenteritis, miscarriage, pelvic inflammatory disease (PID), endometriosis or even appendicitis.
What is the most common treatment for ectopic pregnancy? ›The most common drug used to treat ectopic pregnancy is methotrexate. This drug stops cells from growing, which ends the pregnancy. The pregnancy then is absorbed by the body over 4–6 weeks. This does not require the removal of the fallopian tube.
What are the nursing interventions for ectopic pregnancy? ›Nursing Interventions
Assess the vital signs to establish baseline data and determine if the patient is under shock. Maintain accurate intake and output to establish the patient's renal function.
What should be the priority nursing diagnosis? ›
Nursing diagnoses are ranked in order of importance. Survival needs or imminent life-threatening problems take the highest priority. For example, the needs for air, water, and food are survival needs.
What is the clinical analysis of ectopic pregnancy? ›Clinical Presentation
The patient may be asymptomatic or present with signs and symptoms similar to those of tubal pregnancy, including the classic triad of mild to moderate pelvic or lower abdominal pain, vaginal bleeding, and amenorrhea/menstrual irregularities (Box 2).
Methotrexate is most effective in early ectopic pregnancy, usually when the pregnancy hormone 'beta hCG' level is below 5000 mIU/mL. The treatment is given by means of an injection.
What are the goals of treatment of ectopic pregnancy? ›Medical therapy of ectopic pregnancy is appealing over surgical options for a number of reasons, including eliminating morbidity from surgery and general anesthesia, potentially less tubal damage, and less cost and need for hospitalization.
What is the main cause of ectopic pregnancy? ›A tubal pregnancy — the most common type of ectopic pregnancy — happens when a fertilized egg gets stuck on its way to the uterus, often because the fallopian tube is damaged by inflammation or is misshapen. Hormonal imbalances or abnormal development of the fertilized egg also might play a role.
What are the biomarkers for ectopic pregnancy? ›It is a glycoprotein hormone produced by trophoblast which maintains corpus luteum. Currently, β-hCG is the only biomarker used clinically in the diagnosis of ectopic pregnancy[4].
Does free fluid always mean ectopic? ›The presence or absence of peritoneal free fluid is not a reliable indicator of whether an ectopic pregnancy has ruptured.
How often are ectopic pregnancies misdiagnosed? ›Rates of ectopic pregnancies have been steadily increasing, however at least 40% of cases are initially misdiagnosed as a non-pregnancy condition or suspected intrauterine pregnancy (IUP).
At what hCG level can ectopic be seen? ›An ectopic pregnancy can be suspected if the transvaginal ultrasound examination does not detect an intrauterine gestational sac when the β-hCG level is higher than 1,500 mIU per mL.
Do you test positive if ectopic? ›Would an Ectopic Pregnancy Show Up on a Home Pregnancy Test? Since ectopic pregnancies still produce the hormone hCG, they'll register as a positive home pregnancy test. People with ectopic pregnancies will also experience early pregnancy symptoms like sore breasts, nausea, spotting, and more.
What is the criteria for diagnosing ectopic? ›
A pelvic exam can help your doctor identify areas of pain, tenderness, or a mass in the fallopian tube or ovary. However, your doctor can't diagnose an ectopic pregnancy by examining you. You'll need blood tests and an ultrasound.
Can you sue for misdiagnosed ectopic pregnancy? ›Yes, you can sue your doctor if he failed to diagnose your ectopic pregnancy. You can sue if your doctor misdiagnosed your ectopic pregnancy specifically based on medical malpractice and negligence. With the assistance of ectopic pregnancy medical malpractice attorneys, you can begin your claim against the doctor.
What is the only ultrasound finding that will confirm an ectopic pregnancy? ›There are findings on ultrasound that are indicative of possible ectopic pregnancy. Positive findings include an empty uterine cavity, decidual cast, a thick echogenic endometrium, or a pseudo-gestational sac in the presence of beta hCG levels above the discriminatory zone.
Is an ectopic pregnancy considered a miscarriage? ›An ectopic pregnancy occurs when a pregnancy develops outside of the womb, usually in one of the fallopian tubes. An ectopic embryo will not survive and the pregnancy will miscarry. The consequences of an ectopic pregnancy can be serious and even life-threatening.
How often does ectopic pregnancy require surgery? ›A pregnancy can't survive outside of the uterus, so all ectopic pregnancies must end. It used to be that about 90% of women with ectopic pregnancies had to have surgery. Today, the number of surgeries is much lower, and many more ectopic pregnancies are managed with medication that prevents them from progressing.
Why is ectopic pregnancy high risk? ›Pregnancies can't continue if they're ectopic because only your uterus is meant to carry a pregnancy. Ectopic pregnancies can become life-threatening, especially if your fallopian tube breaks (ruptures). This is a ruptured ectopic pregnancy, and it can cause severe bleeding, infection and sometimes, death.
What is the outpatient treatment for ectopic pregnancy? ›Sometimes, laparoscopy also can be used to treat the ectopic pregnancy. Laparoscopy is an outpatient surgical procedure requiring general anesthesia. A small telescope called a laparoscope is placed into the abdominal cavity through a small incision (cut) in the navel.
What is the management for unruptured ectopic pregnancy? ›The standard medical treatment for unruptured ectopic pregnancy is methotrexate therapy. Methotrexate is an antineoplastic agent that inhibits cell proliferation by destroying rapidly dividing cells. It acts as a folate antagonist.
What are the 5 priorities of nursing care? ›The five priorities focus on: recognising that someone is dying; communicating sensitively with them and their family; involving them in decisions; supporting them and their family; and creating an individual plan of care that includes adequate nutrition and hydration.
What are the 5 nursing interventions? ›The nursing process functions as a systematic guide to client-centered care with 5 sequential steps. These are assessment, diagnosis, planning, implementation, and evaluation.
What is nursing diagnosis in nursing care plan? ›
The nursing diagnosis is the nurse's clinical judgment about the client's response to actual or potential health conditions or needs.
What is the classic triad of ectopic pregnancy? ›The signs and symptoms of an ectopic pregnancy when unruptured mimic that of a normal pregnancy. However, the classic triad of symptoms of an ectopic pregnancy includes abdominal pain, bleeding per vaginum and amenorrhea/positive urinary pregnancy test.
What are the contraindications for medical management of ectopic pregnancy? ›Relative contraindications include an unruptured mass, >3.5 cm, fetal cardiac activity and a quantitative hCG level which exceeds 6,000–15,000 mIU/ml. These contraindications have been developed to limit treatment to early gestations and those without evidence of early or impending rupture.
What is a conservative treatment for ectopic pregnancy? ›Systematic methotrexate (MTX) is a commonly used conservative first-line treatment for patients with ectopic pregnancy. Other conservative treatment includes laparoscopy, uterine artery embolism or dilation and curettage (D&C) with Foley's balloon tamponade.
What is the conclusion for ectopic pregnancy? ›Ectopic pregnancy confers a greater risk of maternal mortality than either childbirth or legal abortion. An extrauterine gestation is 50 times more likely to result in a maternal death than a first-trimester abortion and 10 times more likely than delivery in the third trimester.
What is the most common site of ectopic pregnancy? ›The commonest site for ectopic pregnancy is the fallopian tube representing 95% with all its parts (intramural, ischemic, and ampullary parts and infundibulum).
What is the pain related to ectopic pregnancy nursing diagnosis? ›Nursing Interventions and Rationales
Pain may vary but is usually a sign that ectopic pregnancy, or fallopian tube, has ruptured. Patients will report stabbing or sharp pain in the lower abdomen with fluctuating intensity. To maintain renal function, especially in the case of shock.
There are findings on ultrasound that are indicative of possible ectopic pregnancy. Positive findings include an empty uterine cavity, decidual cast, a thick echogenic endometrium, or a pseudo-gestational sac in the presence of beta hCG levels above the discriminatory zone.
What is the differential diagnosis of ovarian ectopic pregnancy? ›Differential diagnosis
In a pregnant woman without identifiable intrauterine gestational sac, an ovarian ectopic pregnancy may be misdiagnosed as the following entities that are far more common: corpus luteum cyst with hemorrhage or rupture. tubal ectopic pregnancy.
Nursing Interventions
Upon arrival at the emergency room, place the woman flat in bed. Assess the vital signs to establish baseline data and determine if the patient is under shock. Maintain accurate intake and output to establish the patient's renal function.
How is abdominal ectopic pregnancy diagnosed? ›
Ultrasound findings showing an empty uterus, with a gestational sac or mass outside of the uterus, fallopian tubes, and ovaries confirming the diagnosis of abdominal pregnancy. If the diagnosis of abdominal pregnancy is inconclusive with ultrasound findings, magnetic resonance imaging can be used.
What is the classic symptom triad of ectopic pregnancy? ›However, the classic triad of symptoms of an ectopic pregnancy includes abdominal pain, bleeding per vaginum and amenorrhea/positive urinary pregnancy test. The signs and symptoms of an ectopic pregnancy vary based on whether it is ruptured or not.