Bulacan State University

Malolos, Bulacan
College of Nursing

Case Scenario

Case Scenario 4 Embryonic Demise s/p Dilatation and Curettage

Few days prior to admission, a pregnant client on her first trimester of pregnancy with OB score G4P2 (1121)
had experienced vaginal spotting which prompted her to seek medical consultation. Transvaginal ultrasound was
done which revealed an embryonic demise. This finding resulted to admission for dilation and curettage. Admitting
vital signs and other significant reports were as follows: BP 120/80, Pulse Rate 80, Respiratory Rate 21, and
Temperature 36.3°C; conscious and coherent; abdominal findings showed flabby and soft; internal examination
revealed 1cm open with bleeding. Upon admission, D5LR 1L was hooked and regulated to 30gtts/min and consent for
anesthesia, dilatation and curettage was signed and secured. Prior to actual delivery procedure, a medication of
Cefazolin 1gm has been started TIV ANST then she was transferred to Delivery Room via wheelchair by then. IV
sedation was given by her anesthesiologist, perineal prepping, D and C surgery by attending OB, specimen – saving
for Histopath, postoperative care, and transfer to Recovery Room for 2 hours monitoring were the subsequent events.

On second day of hospitalization the following has been noted on the patient’s chart: (1) IVF to consume, (2) on
diet as tolerated regime, (3) oral medication started, and (4) medications such as Cefalexin 500mg cap 3x a day;
Mefenamic acid 500mg cap 3x a day for pain and Methylergometrine tab once a day were ordered. On the 3rd day of
hospitalization, May go home (MGH) orders have been rendered with instructions for home medications and follow up
care after 7 days.

Given a postoperative client preparing for home management, prepare one (1) nursing care plan which best

Level II 2nd Semester SY 2020-2021

address the priority problem of the client and develop a drug study for each medication mentioned above.

Prepared by:

CARMINA O. FABONAN RN
Clinical Instructor