Bulacan State University

Malolos, Bulacan
College of Nursing

Case Scenario
Case Scenario 8 Incomplete Abortion

Patient L is 22 years old, married, gravida 1 para 0, and at 8 weeks of gestation according to her last menstrual
period (LMP). She was rushed to the emergency room department because of complaints of bright red bleeding. She
also reported intermittent lower abdominal cramping and verbalized, “Two days ago, nagpregnancy test ako positive
result. Then kanina, natakot ako kasi nagkaroon ako ng bleeding at kasabay nun masakit yung puson ko kaya
nagpadala na ko sa ospital”.
Her vital signs are as follows: blood pressure is 110/70 mmHg, pulse rate is 82 beats per minute, respiration is
22 breaths per minute, temperature is 37.2 degrees Celsius. She does look pale and she appeared to be in some
discomfort from the cramping due to her facial grimace and guarding behavior. She has lightheadedness, dizziness,
nausea, vomiting, or focal pain. Although she had not experienced any nausea or vomiting, she reported continued
breast tenderness. She also has not experienced any trauma, no recent sexual intercourse and no changes in vaginal
discharge before onset of bleeding. She already has saturated 4 pads within one and a half hour.
An ultrasound examination was performed. An intrauterine pregnancy was noted, with a fetus but no fetal
cardiac activity was noted and a collapsing gestational sac. A diagnosis of incomplete abortion was made. Bleeding
was continuous.
She was then asked to sign for consent to dilatation and curettage. Medications were ordered to the nurse as
follows: Misopristol 400 mcg sublingual, Oxytocin 10 IU ampule to be incorporated to ongoing IVF and Methergine 0.2
mg ampule IM to be administered right after delivery and evacuation of the fetus.

Level II 2nd Semester SY 2020-2021

INSTRUCTIONS:

From the foregoing information, please prepare and submit the following:
1. One (1) NCP that best accommodates the client’s healthcare needs
2. Drug study from ALL given medications.

Prepared by:

RHEALEEN V. VICEDO RN, MAN

Clinical Instructor