Ectopedic Assessment

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We are dispatched to a patient “Mrs A” who is 7 weeks into her pregnancy. Mrs A has experienced some brown PV spotting. During most pregnancies this is regarded as normal and will usually occur around the same time that Mrs A period would occur. This may last for up to two days. Studies have suggested that this could be caused by hormones that control Mrs A’s menstrual cycle, triggering the bleeding known as breakthrough bleeding. Alternatively, it could be the fertilised egg embedding into the uterus lining causing bleeding (implantation bleeding). Unfortunately, bleeding in early pregnancies can also be a sign of a miscarriage or an ectopic pregnancy. Mrs A’s bleeding has recently turned to bright red and this has increased to a 20cm size…show more content…
This is often an assessment of her vital signs and an observation of the patient, signs of shock may be present whether she is compromised or not. These signs may be subtle such as, confusion or weakness and may indicate a more serious condition. Tachycardia, which is usually associated with stage 2 shock, may be absent. We will do a careful abdominal examination on Mrs A to evaluate for tenderness or potential irritation as well as to asses uterine size (often not palpable abdominally). A pelvic examination will also be performed. This is to evaluate the presence of clots, or fetal tissue, and the degree of vaginal bleeding (Dart, Kaplan, Varaklis,…show more content…
This will include the location of this pain and the intensity of it, and does it differ from her menstrual pain. We will also assess for orthostatic vital sign changes and if the amount of virginal bleeding as there is a potential for heavy blood loss during a miscarriage. This loss can quickly develop into hemorrhagic shock (Bledsoe, porter, Cherry, 2011). Our initial assessment and treatment will focus on Mrs A, ABC’s. If Mrs A is deemed compromised, hypertensive and is still actively bleeding we will place Mrs A into a comfortable position and begin to treat her for shock with oxygen therapy and bi-lateral IV access along with an initiation of an isotonic solution for fluid resuscitation. We must also consider the likelihood of an ectopic pregnancy as patients who present with ectopic pregnancies can commonly present with the same symptoms as Mrs A. The most common complaint for an ectopic pregnancy is abdominal pain (Houry, Keadey, 2007). Research has also suggested that although bleeding is most commonly present in a miscarriage, the severity of bleeding does not always correlate with the patient proceeding to have a complete miscarriage. It is estimated that 50% of pregnant patients with vaginal bleeding will go on to have a viable pregnancy (Ramakrichnan, Scheild,
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