Mrs.

F, G3P2+0, 38 years
old

Precipitating Factor:
Predisposing Factor:
 Previous ectopic pregnancy
 Pelvic inflammatory disease Ruptured ectopic  Age > 35 years
(PID) pregnancy  History of infertility
 Certain STIs  Smoking
 Endometriosis
 Prior fallopian tube surgery
Unknown

Implantation of the Embryo releases human Progesterone maintains

developing blastocyst chorionic gonadotropin (B- the endometrial lining
outside uterine cavity hCG) which prevents shedding

(+) Cervical motion Empty uterine cavity, fetus floating

Supports the corpus Amenorrhea
tenderness freely in the Douglas pouch
Pregnancy cannot survive Penetration of ovum into luteum to continue
producing progesterone
without the uterine the muscular wall of the
Pregnancy test (hCG) Digital vaginal examination Bedside pelvic examination
endometrium fallopian tube

Maternal blood extrudes

Distended and tender through the fallopian tube
Increased WBC abdomen with suggestive and into the peritoneal
peritonitis cavity Management:
Superficial and deep
palpation Medical:
Laparotomy with possible saplingectomy
Tubal distention Diagnostic exam (BT, UA, HBSAG)
Foley catheter insertion
Management: Observe for unusualities
Tachycardia
Monitor vital signs
Medical: Blood transfusion if directed by the physician
1. Monitor nature, severity, locations, and Intra-abdominal Hypotension, BP: 90/42
duration of pain. Keep patient NPO hemorrhage mmHg
Monitor vital signs Pharmacologic:
2. Assess the client’s mental and
Acute pain Pelvic ultrasound Manifested signs of Administer Furosemide as ordered by the
emotional response. physician
anemia
3. Provide a quiet environment or Start IVF D5LR as ordered
diversional activities. Pharmacologic:
Hemoperitoneum Administer Ampicillin as directed
Administer Keterolac as
ordered Administer Tramadol as ordered
Aminister Celecoxib as ordered by the physician

1. Explain prescribed treatment and

Tubal ectopic pregnancy provide rationale.
2. Reinforce information provided by
Deficit knowledge other healthcare providers.
3. Allow the patient opportunity to ask
questions and verbalize
Prognosis Risk for infection misconceptions.

Treated: Untreated:
If ectopic pregnancy is Ectopic pregnancy if left
treated maternal death can 1. Adhere to the facility infection control,
untreated can lead to both sterilization, and aseptic policies and
be avoided and the fetal and maternal death.
fallopian tube can be procedures.
Severe internal bleeding 2. Prepare operative site according to
resected and saved. due to the tube bursting specific procedures.
LEGEND: caused by the implanted 3. Identify breaks in aseptic technique
Biographical data egg can lead to the death and resolve immediately upon
of the mother. occurrence.
Risk factors [(/) present; (x) absent]
Initial diagnosis

Etiology

Pathophysiology

Signs/Symptoms

Diagnosis

Management

Final diagnosis

Prognosis

Nursing diagnosis

Nursing intervention