Nursing Care for Ectopic Pregnancy with Shock: Case study

Abstract

A study of Thai pregnant woman was 25 years old. Her chief complaints were lower abdominal pain, dizziness, and fainting about three hours before admission. At admission, she was restless, looked pale and had severe lower abdominal pain. Patient’s temperature was 36.4 degrees Celsius, pulse was 108 times per minute, respiration rate was 22 times per minute and blood pressure was 76/47 mmHg. G2P1A0L1 last 8 years, LMP on 27 January 2020, and no pregnancy test. Per-vagina examination showed a bit of brown discharge and had cervical tenderness. Ultrasound showed free fluid at cul-de-sac and blood intra-abdomen. Urine pregnancy test was positive. She was diagnosed as ruptured ectopic pregnancy with shock. The immediate treatments composed of providing intravenous fluid and blood transfusion and setting emergency surgery for salpingectomy. Patient’s health problems included shock from ruptured related to surgical wound. As for psychological aspect, anxiety about the disease and operative treatment and met grief due to loss of pregnancy and fallopian tubes.

The nursing role is important in nursing care for patient who had ectopic pregnancy with shock. It is considered as an emergency case in obstetric-gynecological unite. When patient have not been resolved in a timely manner, hypovolemic shock stage will continue to stage of prolong shock, resulting in; less blood supply to various organs, acute renal failure or multiple organ failure. Thus, early assessment of hypovolemic shock signs and symptom is very important. Also, consistently vital sign’s assessment, intravascular fluid maintenance, strictly maintain the hemodynamic of the blood vessels and nursing care based on knowledge and skills for patients specific diseases were required. The nursing care included closely monitoring and continuous holistic nursing, rehabilitation after the patient has passed the crisis with improved respectively and advice knowledge that patients and their families can take care of themselves after discharge. The total hospital admission was five days. When the patient was appointed to follow up at 4- week, she had no infected wound, biopsy showed normal pathology, and she had no complications.