Nursing Care for Ectopic Pregnancy with Shock (A case study)

Abstract

Back ground : Ectopic pregnancy with shock is a crisis condition causing patients suffered from hypoxia due to the failure of blood circulation. The complications of blood circulation failure include respiration failure, hypoxia, hypotension, and acute renal failure. Those complications may be the causal of death in patients. Therefore, it is very important for nurses to be able to perform patients’ assessment at the very early state of shock. Consequently, patients can be treated in timely manner.  

Objective : The purposes of this report were to study the prognosis, health problems, treatments, and patient outcomes. It is expected that knowledge gained from this report will provide resource of nursing practice guideline (NPG) for nurses to care for patients diagnosed from ectopic pregnancy with shock.

Sample and setting : The purposive sampling method was used to select 1 patient diagnosed from ectopic pregnancy with shock. The patient was recruited from Gynaecology unit at Sisaket hospital.

Study design : The retrospective data collection was employed. Data were gathered from the patient’s medical record between January 2, 2009 and January6,2009.

Results : A married Thai woman aged 18 with a report of absence of 1 month period of menstrual was referred to Sisaket hospital from community hospital with lower abdominal pain, faint, alteration of conscious and shock. At Sisaket hospital, shock was worsening progressive.  0.9% Normal Saline Solution and Haemaccel were given intravenous. Later on, the patient’s clinical improved enough to tolerate the operation. Right partial salpingectomy was performed and found hemoperitonieal 2,000 ml. ultimately; the patient’s conditions were dramatically recovered.  In summary, the patient’s health problems were: 1) actual: hypovolemic shock (deficient fluid volume) due to massive blood loss in the abdomen secondary to ectopic pregnancy, 2) actual: ineffective tissue perfusion related to progression of shock with decreased red blood cell to transport oxygen to tissues, 3) risk for: fluid and electrolyte imbalance, 4) actual: anxiety related to feelings that illness was worsening and is potentially life threatening (patient and significant others), 5) actual: pain secondary to tissue injury, 6) actual: anemia due to massive blood loss, and 7) actual: alter in comfort due to abdominal distension secondary to the operation received. Nursing care had been closely provided based on patient’s conditions to correct the shock. Finally, Patient was safe from shock and those mentioned health problems.

Conclusion : In order to provide nursing care for correcting shock, nurses must have knowledge of characteristics of shock and initiate nursing care plan to provide cares and observe patients closely.