Ectopic Pregnancy Case Study

Ectopic Pregnancy Brandi, Mary Gibbs, Sasha, Summer Jean Simmons, 22 years old Primary Concept Perfusion Interrelated Concepts (In order of emphasis) 1. Reproduction 2. Pain 3. Clinical Judgment History of Present Problem: Jean Simmons is a 22-year-old-college student who presents to the emergency department with RLQ abdominal pain and intermittent vaginal bleeding. Her pain started suddenly two hours ago and has been severe and persistent. She noticed a small amount of bright red vaginal bleeding in the last hour. Jean has irregular cycles and it has been six weeks since her last menses, which is not unusual for her. She admits to feeling more fatigued the last couple weeks with intermittent nausea. Jean is 5’ 8” and weighs 74 kg (163 lbs.). Personal/Social History: Jean has been sexually active since the age of 16 and has had three male partners in the last six months. She insists that they use condoms which she provides. She has a history of an ovarian cyst and was treated for pelvic inflammatory disease (PID) six months ago. What data from the histories is RELEVANT and has clinical significance to the nurse? RELEVANT Data from Present Problem: Clinical Significance: -Severe and persistent RLQ abdominal pain began 2 hr ago -Intermittent bright red vaginal bleeding for the past hr -has irregular cycles -6 weeks for since her last menses - fatigued with intermittent nausea -When the embryo outgrows the implantation site, the tube ruptures and there is bleeding into the abdominal cavity which can cause one-sided lower abdominal pain. (Davidson, London, & Ladewig, 2020, p390-393) - “Hormones first stimulate the endometrial lining of the uterus to grow, but fluctuation in levels cannot support the endometrium and vaginal bleeding ensues (Davidson et al., 2020, p390-393).” RELEVANT Data from Social History: Clinical Significance: -sexually active since 16 -3 male partners in past 6 months that used condoms she provided -hx of ovarian cysts - treated for PID 6 months ago -sexually active with multiple males in the past 6 months increases her chances of getting pregnant even though she provided condoms. Condoms are not 100% effective in preventing pregnancy. -tubal damage caused by PID is a risk factor of ectopic pregnancy (Davidson et al., 2020, p390-393). Patient Care Begins: Current VS: P-Q-R-S-T Pain Assessment (5th VS): T: 98.4 F (36.9 C) oral Provoking/Palliative: Movement of any kind/Lying still in fetal position P: 98 (regular) Quality: Sharp/stabbing R: 20 (regular) Region/Radiation: RLQ abdomen BP: 102/52 Severity: 9/10 O2 sat: 98% room air Timing: Constant What VS data is RELEVANT and must be recognized as clinically significant by the nurse? ……………………….CONTINUED……………………………………………….