Family Nursing Exam 3
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Mild: 20% blood loss, Mild Shock
Symptoms: diaphoresis,
increased cap refill, cool
extremities, maternal
anxiety
Moderate: 20-40% blood Moderate Shock
loss Symptoms:
Tachycardia, postural
hypotension, oliguria
Severe: over 40% blood Severe Shock
loss Symptoms:
Hypotension,
agitation/confusion,
hemodynamic instability
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Normally, the fertilized Pathophysiology of Ectopic Pregnancy
ovum implants in the
uterus. In ectopic
pregnancy, the journey
along the fallopian tube
is arrested or altered in
some way. With an
ectopic pregnancy, the
ovum implants outside
the uterus. The most
common site for
implantation is the
fallopian tubes (96%), but
some ova may implant in
the ovary, the intestine,
the cervix, or the
abdominal cavity
Chlamydia infection Risk factors of ectopic pregnancy
resulting in tubal damage
Other associated risk
factors for ectopic
pregnancy include
previous tubal surgery,
infertility, PID, previous
pregnancy loss (induced
or spontaneous), use of
an intrauterine
contraceptive system,
previous ectopic
pregnancy, uterine
fibroids, sterilization,
smoking (which alters
tubal motility), history of
multiple sexual partners,
use of progestin-only
oral contraceptives,
douching, and exposure
to diethylstilbestrol
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The WHO classification Gestational Trophoblastic Disease Definition
of gestational
trophoblastic disease
(GTD) includes disorders
of placental
development
(hydatidiform mole) and
neoplasms of the
trophoblast
(choriocarcinoma)
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Treatment consists of Gestational Trophoblastic Disease Therapeutic
immediate evacuation of Management
the uterine contents as
soon as the diagnosis is
made and long-term
follow-up of the client to
detect any remaining
trophoblastic tissue that
might become malignant.
D&C is used to empty the
uterus. The tissue
obtained is sent to the
laboratory for analysis to
evaluate for
choriocarcinoma. Serial
levels of hCG are used to
detect residual
trophoblastic tissue for 1
year. If any tissue
remains, hCG levels will
not regress.
As a result of the
increased risk for cancer,
the client is advised to
receive extensive follow-
up therapy for the next 12
months. The follow-up
protocol may include:
Baseline hCG level, chest
radiograph, and pelvic
ultrasound
Quantitative hCG levels
every week until
undetectable for three
consecutive weeks; then
serial hCG levels monthly
for 1 year
Chest radiograph every 6
months to detect
pulmonary metastasis
Family Nursing Exam 3 Family Nursing Exam 3.pdf Family Nursing Exam 3.pdf