Question

. The client is admitted to the emergency room with a tentative diagnose of ectopic pregnancy. The nurse should be least concerned with: ? A. Controlling bleeding ? B. Preventing infection ? C. Preserving the pregnancy ? D. Controlling pain

Short answer

Answer: Preserving the pregnancy

Step-by-step solution

Understanding Ectopic Pregnancy

Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in a fallopian tube. This condition can be life-threatening for the mother, as the growing embryo can cause the fallopian tube to rupture, leading to severe internal bleeding. The primary goals of management in this situation are to stabilize the patient, control bleeding, and prevent complications such as infection.

Analyzing the Options

Now, let's analyze each option: A. Controlling bleeding: This is a high priority, as internal bleeding can be life-threatening for the patient. B. Preventing infection: It is important to ensure that the patient does not develop any infections from the procedure to prevent complications. C. Preserving the pregnancy: Since an ectopic pregnancy cannot progress normally, the only option is to remove the embryo, either with medication or surgery. Therefore, preserving the pregnancy is not a priority in the treatment process. D. Controlling pain: Pain management is essential for providing comfort, but it might not be as high of a priority as controlling bleeding or preventing infections.

Selecting the Correct Answer

Based on the priorities of managing ectopic pregnancy, it's clear that the nurse should be least concerned with preserving the pregnancy (Option C), as it cannot progress normally. The main priorities are to stabilize the patient, control bleeding, and prevent complications such as infections and severe pain.

Key concepts

Nursing Priorities in Ectopic Pregnancy

When managing a patient with an ectopic pregnancy, certain nursing priorities must be established due to the critical nature of the condition. The top priority is to stabilize the patient's condition effectively. Severe internal bleeding is a common risk, demanding prompt intervention to control and stop the hemorrhage. Without immediate care, the bleeding can become life-threatening.
Another significant priority is ensuring the prevention of infections. As the procedure to resolve an ectopic pregnancy may involve surgery or medication, there is always a potential risk of infection. Appropriate prophylactic measures should be employed to safeguard the patient’s recovery process.
Pain management, while important for patient comfort, often comes after stabilizing the patient and preventing infections. Pain can indicate complications; hence, it must be monitored carefully.

• Stabilizing the patient and controlling internal bleeding.
• Preventing infections post-procedure.
• Managing pain while monitoring for signs of complications.

Understanding these priorities helps nurses focus on what is crucial in emergency settings and provides the best possible care for the patient.

Ectopic Pregnancy Management Strategies

Ectopic pregnancy management involves a comprehensive approach due to its urgent and sensitive nature. The primary goal is the resolution of the pregnancy since it cannot progress normally. This typically means removing the embryo from its ectopic location, often via medication or surgical intervention.
A commonly used medication is methotrexate, which halts cells from dividing, allowing the body to absorb the pregnancy tissue over time. Surgical options may include laparoscopic surgery to physically remove the embryo and repair any damage to the fallopian tube or surrounding tissues.
Early diagnosis and intervention are crucial to preventing severe complications such as ruptured fallopian tubes, which can cause significant internal bleeding. This highlights the necessity of diagnostic imaging techniques and thorough patient assessment immediately upon suspicion of an ectopic pregnancy.

• Immediate intervention to remove the ectopic pregnancy.
• Methotrexate as a non-surgical option for early cases.
• Laparoscopic surgery for advanced cases or complications.

Effective management ensures patient safety and reduces long-term health risks.

Emergency Nursing Care Procedures

In emergency nursing scenarios like an ectopic pregnancy, care procedures are critical to patient outcomes. Nurses must act swiftly and decisively while maintaining clear communication with the patient and the medical team.
Initial steps involve assessing the patient's vital signs and symptoms. Immediate interventions include intravenous access for fluid and medication administration, providing oxygen, and preparing for potential surgical intervention.
Communication is a cornerstone of emergency care. Educating the patient about their condition and treatment plans helps reduce anxiety and aids in informed consent for treatment.
Throughout the emergency care process, nurses should remain attentive to changes in the patient’s condition, providing updates to the team and adjusting care plans as necessary. This ensures that all team members are aligned and can respond efficiently to changes.

• Rapid assessment and stabilization as priority.
• Building effective communication with the patient and team.
• Continuous monitoring and adapting care plans.

These steps form the backbone of effective emergency nursing care, prioritizing patient health and safety.