You are a RN coming onto PM shift. A patient is being sent over urgently from the Maternal Fetal Medicine office. You have not been given report. The patient is being wheeled in slowly by her partner. The patient is slumped over in the wheel chair, crying, and guarding her right lower abdomen. You walk up to her and help the patient into a labor room. The patient reports “super sharp pain on my right side and its just constant and I can’t walk and I feel so sick”. The patient stated that she thinks that she is 6 weeks pregnant and she’s had multiple positive pregnancy tests. The patient is vomiting, pale, diaphoretic, and breathing heavily. Her partner smells like marijuana and is at the bedside holding the patient’s hand.
List the various risk factors or red flags you see in this case.
What other information would you want to know about this patient?
What assessments would you want to do?
What is the likely diagnosis(s)?
How would you manage her support person?
Answer 1. sharp constant pain on the right lower abdomen, paleness,diaphoresis and heavy breathing.
Answer 2. Information about previous history of ectopic pregnancy and/ or abortion, IVF treatment,smoking, presence of vaginal spotting or vaginal bleeding.
Answer 3. Assessment include abdominal assessment , Complete blood count, ultrasonography, assess for vaginal spotting and bleeding, assess respiratory rate, oxygen saturation.
Answer 4. The likely possible diagnosis for the mention case is ectopic pregnancy or ruptured ectopic pregnancy.
Answer 5. Explain the patient's condition to her partner. Explain the management required to be done in this case. explain that marijauna is harmful for the fetus as the smoke can affect the baby brain development and can also cause premature delivery and low birth weight.
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