Nursing Care for ectopic pregnancy: Case study 2 case

Abstract

Background : Ectopic pregnancy is an emergency high risk condition in reproductive aged women. A ruptured tubal ectopic pregnancy with excessive blood lost resulted in patient shock and maternal death. Clinical observation and proper care are needed. Nurses are healthcare professional who closelycare for patients have to competence in providing care compliance with nursing standard.

Objective : To study nursing care for two patients with ectopic pregnancy compliance with nursing standard.

Methods : The purposive sampling method was used to select two patients admitted in Mahasarakham hospital in fiscal year 2019.Patient’s history from the patients, relatives, and patient records. Nursing diagnosis was list using Gordon’s 11 functional health patterns. And nursing care was performed base on five steps of nursing process.

Results : The first case study was a Thai reproductive aged woman, gravida 2, para 0, abortion 1, reported severe dysmenorrhea 30 minutes before admission. The ultrasonography showed ruptured ectopic pregnancy at right fallopian tube with shock. In order to treat shock and emergency surgery was performed. After surgery there were no complications after treatment for shock and care. The hospital stay for this patient were three days. The second case study was a Thai reproductive aged woman, gravida 3, have had tubal ligation after 2nd birth. The patient reported left lower quadrant abdominal pain with vaginal bleeding 1 week before admission. Her urine pregnancy test showed positive result. Ultrasonography showed a non-rupture left tubal ectopic pregnancy. The patient was well prepared for surgery. After surgery, the patient wakes up from anesthesia with full consciousness. She received post-operative nursing care and no complications were found. The patient stays in the hospital for three days.

Conclusion : Two case studies, both have been diagnosed with tubal ectopic pregnancy at the ampulla part and received surgery. The first patient has been diagnosed with ruptured ectopic pregnancy with shock and need emergency surgery. The second patient have a non-rupture ectopic
pregnancy. This patient received pre-operative preparations. Nurses who care for patients, specific nursing competencies needed to provided effective, accurate, systematic and prompt nursing care for patient base on nursing process, nursing standard and continuity of care including knowledge, health assessment skill, and collaborative skill.