Topic: Abortion

Diagnostic Test / Screening

Test

Pelvic exam. The

doctor will check to see
if the cervix has begun to
dilate.
Ultrasound. This
helps the doctor check
for a fetal heartbeat and
determine if the embryo
is developing normally.
Blood tests. If the
mother miscarried,
measurements of the
pregnancy hormone, beta
HCG, can occasionally
be useful in determining
if the mother has
completely passed all
placental tissue.
Tissue tests. If the
mother passed tissue, it
can be sent to the
laboratory to confirm that
a miscarriage has
occurred and that the
mothers symptoms aren't

Assessment Findings /
Signs and Symptoms
Presence of:
Mild/severe
back pain.
Heavy
spotting.
Vaginal
bleeding.
Expulsion of
tissue with
clots from the
vagina.
Severe
abdominal
pain.
Cramps.
Reference:
http://www.healthline.
com/health/miscarriag
e#Causes3 (2005)

Nursing Diagnosis /
Nursing Problem

Management / Nursing Intervention / Care

Pharmacologic management
and Nursing responsibility

1. Anticipatory
grieving
related to
loss of
pregnancy
cause of
abortion.

1. Assess the reaction of patient and

support person -encourage the
patient to discuss feelings about the
loss of the baby including the
effects on relationship with father

Pharmacologic management

Hui-Ming, (2014)
2. Severe
Anxiety
Turchetto, et al,
(2014)
3. Moderate
Powerlessne
ss
Saunders, (2012)
4. Fluid
Volume
Deficit
related to
Massive
Blood Loss
Secondary
to

Use of pharmacological
drugs to terminate pregnancy.
Sometimes the terms nonsurgical abortion or
Providing time alone for the couple medication abortion are
also used. Medical methods
to discuss their feelings.
of abortion have been
Make time to listen to client.
developed throughout the
world and are now a standard
Review past life experiences like
method of providing abortion
previous loss and coping skills
care in the United States.
Medical abortion, which
Provide therepeutic touch as
involves the use of
individually accepted.
medications rather than a
Provide an open, non- judgemental surgical procedure to induce
an abortion, is an option for
environment
women who wish to
Provide health teaching to a
terminate a first-trimester
pregnant patients and to their
pregnancy. Although the
partners.
method is most commonly
used up to 63 days of
Hui-Ming, (2014)
gestation (calculated from
http://www.slideshare.net/da_hm.yk/anticip
the first day of the last
atory-grieving-related-to-pregnancy-lossmenstrual period), the
ncp
treatment also is effective
2. Monitor vital signs and changes in blood after 63 days of gestation.

related to another cause

of pregnancy bleeding.

Spontaneou
s Abortion.
RNspeak.com,
(2011)

Reference:
http://www.mayoclinic.org/di
seases-conditions/pregnancyloss-miscarriage/basics/testsdiagnosis/con-20033827
(2013)

pressure

Identify client's perception of the

loss of pregnancy

Establish therapeutic relationship

Assist client to develop selfawareness of verbal and nonverbal

behaviors.

Clarify meaning by providing

feedback and checking meaning
with the client.

Avoid excessive reassurance; this

may reinforce undue worry.

Explore coping skills previously

used by client to relieve anxiety;
reinforce these skills and explore
other outlets.

Turchetto, et al, (2014)

http://nandanursing.com/anxiety-nursinginterventions-and-rationales.html
3. Make time to listen to client's
perceptions and concerns and encourage
questions

Express hope for the client

Obtain information from client and

significant others regarding client's
usual response to situations in
which he/she has had limited
control

Include client in the planning of

Example drugs:
Mifepristone
Mifepristone, a derivative of
norethindrone, binds to the
progesterone receptor with
an affinity greater than
progesterone itself but does
not activate the receptor,
thereby acting as an
antiprogestin
Misoprostol
Misoprostol is an
inexpensive prostaglandin
E1 analogue in a tablet form
that is stable at room
temperature.
Nursing Responsibilities
Ultrasound assessment of
gestational age
Pre & post abortion
counselling
Administration of
abortificants
Discharging patients
Vaginal/speculum
examination
Assessment for &
provision of
contraception
Obtaining consent for
abortion procedures
Obtaining consent for
abortion procedures

Obtaining consent for

abortion procedures
exceptions
Under 16 unaccompanied
by an adult with parental
responsibility
Encourage significant others to
The woman does not
allow client to do as much as he/she
understand the
is able so that a feeling of
procedures
independence can be maintained.
The woman is unsure
The woman has
Saunders, 2012
bleeding / pelvic pain
http://www1.us.elsevierhealth.com/SIMON
/Ulrich/Constructor/diagnoses.cfm?did=51 A medical condition
that is contraindicated
4. Assess patient condition by getting vital

The nurse/midwife deems

signs, urinary input and output
it unsafe
Establish 24-hour fluid
References:
replacement. increase fluid intake
http://www.wales.nhs.uk/site
by oral and encourage the patient to splus/documents/888/Alison
frequent intake.
%20Jones2.pdf
Administer IV fluid if indicated.
care, encourage maximum
participation in the treatment plan,
and allow choices whenever
possible to promote a sense of
control.

Assess patients frequency in

changing her sanitary napkins.

Provide health teaching and remind

the important of follow up check-up
if necessary.

RNspeak.com, 2011
http://embed.docstoc.com/docs/documentpreview.aspx?doc_id=144148186

Besa, James Matthew M. Diagnostic Test / Screening Test, Assessment Findings / Sign and Symptoms

Bucatot, Abbe Gayle Nursing Diagnosis / Nursing Problem, Management / Nursing Intervention / Care

Caabay, Helen Rose Pharmacologic Management and Nursing Responsibilities