Complications of Early Pregnancy

A patient presents to the perinatal clinic with abdominal pain. She has missed one period and, following a transvaginal ultrasound, pregnancy is confirmed. However, implantation has occurred in the right fallopian tube. The ectopic mass is 3 cm and has not ruptured. The nurse prepares the patient for which therapy?

• Laparoscopic salpingectomy

• Methotrexate

• Partial salpingectomy

• Salpingectomy by laparotomy

A nurse is caring for a patient who has been diagnosed with an incomplete molar pregnancy. Which action by the nurse is most appropriate?

• Advise the patient that she can try to get pregnant in three months.

• Arrange a consultation with a radiation oncology nurse.

• Facilitate screening for systemic lupus erythematosus.

• Give the patient information on perinatal loss support groups.

A patient who recently had a miscarriage is in the clinic for follow-up. She sees the diagnosis “spontaneous abortion” on her chart and becomes visibly upset, stating, “I did not have an abortion!” Which response by the nurse is best?

• "Don't be upset. This is just a medical term used commonly."

• "I can come back and talk to you when you are not so upset."

• "I see you are upset. Does it help to know this means miscarriage?"

• "No one is accusing you of having an abortion."

A nurse is assessing a patient in the perinatal clinic with diagnosed cervical insufficiency. The patient is in her 18th week of a viable pregnancy. Which action by the nurse is most appropriate?

• Assist with obtaining informed consent for a cerclage.

• Draw blood to assess the maternal Rh status.

• Facilitate a transvaginal and abdominal ultrasound.

• Refer the patient to a perinatal grief specialist.

A nurse is caring for a client undergoing treatment for ectopic pregnancy. Which of the following symptoms is observed in a client if rupture or hemorrhaging occurs before successfully treating the ectopic pregnancy?

• Shoulder pain (phrenic nerve irritation)

• Painless bright red vaginal bleeding

• Fetal distress

• Tetanic contractions

The nurse is required to assess a pregnant client who is complaining of vaginal bleeding. Which of the following assessments should be considered a priority by the nurse?

• Monitoring uterine contractility

• Assessing signs of shock

• Determining the amount of uterine funneling

• Assessing the amount and color of the bleeding

A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states, “I missed one menstrual cycle and cannot be pregnant because I have an intrauterine device.” The nurse should suspect which of the following?

• Missed abortion

• Ectopic pregnancy

• Severe preeclampsia

• Hydatidiform mole

A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea; vomiting; and scant, prune-colored discharge. The client has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect?

• Hyperemesis gravidarum

• Threatened abortion

• Hydatidiform mole

• Preterm labor

A pregnant woman who is at approximately 12 week's gestation comes to the emergency department after calling her health care provider's office and reporting moderate vaginal bleeding. Assessment reveals cervical dilation and moderately strong abdominal cramps. She reports she has passed some tissue with the bleeding. The nurse interprets these findings to suggest which of the following?

• Threatened abortion

• Inevitable abortion

• Incomplete abortion

• Missed abortion

A woman is being discharged after receiving treatment for hydatifdiform molar pregnancy. The nurse should include which information in discharge teaching?

• Do not become pregnant for at least a year; use contraceptives to prevent it.

• Have your blood pressure checked weekly in the clinic.

• RhoGAM must be given within the next month at the clinic.

• An amniocentesis can detect a recurrance of this disorder in the future.