ECTOPIC PREGNANCY

DEFINITION

An ectopic pregnancy is a pregnancy complication that happens when the implantation of the
fertilized egg occurs outside the uterine cavity either on the surface of the ovary, in the cervix,
in the abdomen and most commonly in the fallopian tube.

SIGNS AND SYPMTOMS

The following symptoms may be used to help recognize a potential ectopic pregnancy:

 Sharp or stabbing pain that may come and go and vary in intensity
 Vaginal bleeding, heavier or lighter than your normal period
 Gastrointestinal symptoms
 Weakness, dizziness, or faintaing

COMPLICATIONS

A complication of ectopic pregnancy is more likely if diagnosis or treatment is delayed, or if the

condition is never diagnosed. The most common complication is the rupture of the internal
bleeding that may cause hypovolemic shock. Another are the damage to fallopian tube and
depression.

RISK FACTORS

Age (usually maternal age of 35-44); endometriosis (can result in the formation of scar tissue
and adhesions which may interfere with the ability of the fertilized egg to reach the uterus;
history of sexually transmitted infection or pelvic inflammatory disease, and tubal surgery;
and previous ectopic pregnancy.

MEDICATION AND INTERVENTIONS

Administration of Methotrexate (Rheumatrex). A drug that stops the growth of rapidly dividing
cells, such as the cell of the ectopic mass.

A laparoscopic surgery under general anesthesia may also be performed. If the ectopic
pregnancy cannot be removed by this, a laparotomy may be done. It is where a doctor will
insert a small camera through a small incision to make sure they can see their work. Then the
surgeon will remove the embryo and repairs any damage to the fallopian tube.
NURSING INTERVENTION

 Assess the vital signs to establish baseline data and determine if the patient is under
shock.
 Assess for signs of dehydration; skin turgor, mucous membranes, capillary refill to
provide medical attention to it that may cause by excessive blood loss and vomiting due
to ectopic pregnancy.
 Maintain accurate intake and output to establish the patient’s renal function.
 Place the patient in lying flat position on bed for comfort and assist with movement as
needed to minimize movement and stabilize vitals.
 Assess for abdominal pain and tenderness.
 Monitor blood loss and administer blood products as necessary.
 Administer medications as prescribed
 Provide patient education of ways to prevent future ectopic pregnancies.

Nursing Care Plan for Ectopic Pregnancy

ASSESSMENT

Subjective: "Masakit ang tiyan ko" as verbalized by the patient.

Objective: Facial mask of pain and guarding behavior

DIAGNOSIS: Acute pain related to rupture of fallopian tube

PLANNING: After 8 hours of intervention, the patient will be relieve or control the pain.

INTERVENTIONS

Independent:

1. Monitor the maternal vital signs

Rationale: To determine presence of hypotension and tachycardia cause by rupture or hemorrhage.

2. Monitor for the presence and amount of vaginal bleeding.

Rationale: To further assess the present situation indicating hemorrhage.

3. Monitor for increase pain, abdominal distention and rigidity.

Rationale: Increase pain and abdominal distention indicates rupture and possible intraabdominal
hemorrhage.

4. Provide comfort measures such as back rubs and deep breathing.

Rationale: To promote relaxation and may enhance patient's coping abilities.

Dependent:

1. Administer analagesics as indicated.

Rationale: To maintain acceptable level of pain.

EVALUATION

Goals met. After 8 hours of intervention, the patient was able to relieve and control the pain.