OUR LADY OF FATIMA UNIVERSITY - VALENZUELA CAMPUS

College of Nursing
120 MacArthur Highway, Valenzuela, 1440 Metro Manila

A Maternal and Child Nursing Case Study on Ectopic Pregnancy

Submitted by:
Group 2B
CARAECLE, LESLIE T.
CARONAN, MAKAYLA S.
COMIA, SHAQUIRA ANDREA D.
DE JESUS, MA. KRISTINA CASSANDRA B.
DELOS SANTOS, JD M.
GADO, ANGEL G.
GONZALES, ALYSSA KAYE S.
GOZON, CLAIRE DANIELLE S.
GUNAY, SHANIA LEE C.

Submitted to:
Prof. Melania Concepcion RN, MAN
 TABLE OF CONTENTS

I. Introduction

II. Learning Objectives

III. Patient’s Profile

IV. Physical Assessment

V. Anatomy and Physiology

VI. Pathophysiology

VII. Laboratories and Diagnostic Procedures

VIII. Course in the Ward

IX. Drug Study

X. NCP 1, NCP 2, NCP 3

XI. Discharge Planning

I. INTRODUCTION

Ectopic Pregnancy is a critical medical condition where a fertilized egg develops outside the uterus, usually in the
fallopian tube. It is a gynecological emergency because of severe risks including tube rupture and internal bleeding. Common
symptoms are abdominal pain and vaginal bleeding. Early diagnosis is crucial for prompt treatment. Diagnosing ectopic
pregnancy can be difficult due to similarities of symptoms with other gynecological and abdominal conditions. Different
diagnostic procedures such as transvaginal ultrasound and hCG test is done to confirm diagnosis

In ectopic pregnancy, the embryo attaches to a different surface rather than implanting on the uterine wall, mostly in the
fallopian tube, but it can also implant in the cervix, abdomen, and ovaries. Women with a history of PID, had a surgery in the
fallopian tube, and uses IUD are susceptible to ectopic pregnancy. Treatment for this varies depending on the severity of the
condition, if it is unruptured, it can still be regulated with medications such as methotrexate and leucovorin. Ruptured fallopian
tube requires emergency surgical procedures to prevent further complications.
 II. LEARNING OBJECTIVES

General Objective
- This study collectively aims to improve the early detection, management, and prevention of ectopic pregnancy; to educate
individuals about ectopic pregnancy risk factors, symptoms, and the importance of seeking medical attention.

Specific Objective/s:

- To advance knowledge and improve outcomes related to ectopic pregnancy.

- To raise public awareness about ectopic pregnancy and its potential risk.
- Increase awareness among individuals of reproductive age about ectopic pregnancy and its predisposing factors.
- Identify the signs and symptoms of ectopic pregnancy.
- Recognize classic symptoms such abdominal pain, vaginal bleeding, and shoulder pain.
 III. PATIENT’S PROFILE

NAME: A.A.A.
SEX: Female
AGE: 25 y/o
RELIGION: Catholic
CIVIL STATUS: Single
OCCUPATION: Street Vendor
NATIONALITY: Filipino
DATE OF ADMISSION: September 08, 2023
TIME: 2:00 PM
CHIEF COMPLAINT: Vaginal Bleeding, 2 pads fully soaked
ADMITTING DIAGNOSIS: G4P2 (2012) Ectopic Pregnancy 10 2/7 weeks AOG, Probably Ruptured

BASELINE VITAL SIGNS

TEMPERATURE: 36.2℃
PULSE RATE: 76 bpm
RESPIRATORY RATE: 20 cpm
BLOOD PRESSURE: 110/70 mmHg
WEIGHT: 40.5 kg
HEIGHT: 147 cm

HISTORY OF ILLNESS
PAST MEDICAL HISTORY:
● U/R
● The patient has no surgical history and blood transfusion
PRESENT MEDICAL HISTORY:
7 days PCC while cooking, patient experienced hypogastric pain and lower back pain, pain scale 6/10, intermittent, around 10 mins
per episode, probably relieved by loss and increased fluid intake but recurs for about 5 hours. Patient was confined at St. Gerard
General Hospital and was prescribed Duphaston thrice a day for 7 days, and FeSO4 once a day, but only took the medication for 3
days and by then the vaginal bleeding had reoccurred. 2 days PCC, patient returned for consult and transvaginal ultrasound, ectopic
pregnancy was confirmed. Patient presented at Valenzuela Medical ER Department for further management.

OBSTETRICAL HISTORY:
● G1 2017, LIVE TERM, NORMAL SPONTANEOUS DELIVERY, MALE
● G2 2019, ABORTION, APPROXIMATELY 20 WEEKS AOG
● G3 2020, LIVE TERM, NORMAL SPONTANEOUS DELIVERY, MALE
● G4 2023, ECTOPIC PREGNANCY

MENSTRUAL HISTORY
● Menarche occurs when the patient was 11 years old
● Regular Period
● 3 pads every menstruation
● Menstruation lasts for 3 days
● (+) Dysmenorrhea
IV. PHYSICAL ASSESSMENT

PART RESULT

Skin - Good skin turgor, Capillary Refill Time less than 2

seconds, Negative skin lesions indicates that the skin
appears to be healthy and hydrated with good elasticity,
and there are no visible skin lesions or circulation issues
detected during the examination.

HEENT - Auscultation in the supraclavicular area was performed,

and Negative for Cerumen, Lesions, Alopecia, or
Deformities

Heart - The apical pulse was assessed, and the findings were
within normal parameters in terms of heart rate, rhythm,
and regularity. This is generally a positive sign indicating
that the heart is functioning normally at the time of the
assessment.

Lungs - The chest expansion is symmetrical, and clear breath

sounds were heard during the assessment. These
findings are typically considered normal and suggest that
there are no significant respiratory problems at the time
of the examination.

Abdomen - Soft, nontender indicates that the abdomen felt soft and
there was no tenderness or pain detected during the
examination.

Genitalia - Grossly normal indicates that, upon visual inspection the

genitalia appear to be within the expected range of
normal appearance and there are no obvious
 abnormalities, lesions, or significant issues detected
during the examination.

Extremities - No noticeable swelling or accumulation of fluid in the

extremities. Negative cyanosis indicates that there is no
bluish or purplish discoloration of the extremities. Full
equal pulses.
 V. ANATOMY AND PHYSIOLOGY

The uterus is located between the urinary bladder anteriorly and the rectum posteriorly.

The uterus subdivides into three segments, namely: the body, the cervix, and the fundus.
Fundus

Is the broad curved upper area in which the fallopian tubes connect to the uterus.

● help balance appropriate hormones during pregnancy

● aids in protection of the fetus
● important in reproductive health

Body

The main part of the uterus starts directly below the level of the fallopian tubes and continues downward until the uterine walls and
cavity begin to narrow.

● ultimately its cells' functions

● a state of relative constancy, of its internal environment.
● basic life activities include organization, metabolism, reaction, mobility, and reproduction.

Isthmus

The lower, narrow neck region; and the lowest section, the cervix, extends downward from the isthmus until it opens into the vagina.

● a small region, only about 2 cm (0.8 inch) long

● connects the ampulla and infundibulum to the uterus
● final region of the fallopian tube
 The uterus has three tissue layers which include the following:

Endometrium

The inner lining consists of the functional (superficial) and basal endometrium. The functional layer responds to reproductive
hormones.

● preparation for implantation

● maintenance of pregnancy if implantation occurs
● menstruation in the absence of pregnancy
Myometrium

The muscle layer is composed of smooth muscle cells.

● The thick middle muscle layer of the corpus or fundus

● Expands during pregnancy to hold the growing baby
● It contracts during labor to push the baby out.

Perimetrium

The thin outer layer is composed of epithelial cells.

● the outer serous layer of the uterus

● secretes a lubricating fluid that helps to reduce friction
● part of the peritoneum that covers some of the organs of the pelvis.
VI. PATHOPHYSIOLOGY
VII. LABORATORIES AND DIAGNOSTIC PROCEDURES

1. Urine Pregnancy Test

Assessment for ectopic pregnancy includes a pregnancy test. False positive results may occur due to ectopic pregnancy.

2. Blood Tests

Blood tests are done to identify ectopic pregnancy if it does not show on ultrasound scan. Levels of hCG tend to be lower and rise
more slowly over time than in a normal pregnancy. The result of the test can also be useful in determining the best treatment for an
ectopic pregnancy.

3. Ultrasound

This involves inserting a small probe into your vagina to show whether there is a fertilized egg implanted in one of your fallopian
tubes, although it can be very difficult to spot.
VIII. COURSE IN THE WARD

Date/Time Doctor’s Order Focus Nursing Data, Action, and

Response

9/08/23 - Admit patient at OB

2:00 PM ward direct to OR
- Kindly secure consent
for admission and
management
- Nothing by mouth
- IV fluid: Plain NSS 1L
to run at 125 cc per
hour
- Another IV line: Plain
NSS 1L to run at 30 cc
per hour

DIAGNOSTIC:

● CBC
● Pregnancy test
● ABORh
● HBsAg
● Urinalysis
- For ‘E’ Exlap poss.
Salpingectomy left,
secure consent
- Give cefazolin 28 TIV
grady dose an hour
prior procedure
- Secure 2 units packed
RBC
 - Properly typed and
crossmatched
- Kindly inform Aneth,
OR Staff
- Monitor vital signs
every hour
- Monitor input and
output

2:00 PM Proposed Vaginal Bleeding D: Admitted 25 years old,

female with a chief complaint
of vaginal bleeding, T: 36.2 C,
BP: 110/70 mmHg, RR: 20
cpm, PR: 78 bpm

A: Consent secured for advice

and disclosed by the Doctor in
charge. For ‘E’ Exlap poss.
Salpingectomy left with
consent secured.
Secure 2 units packed RBC
properly typed and
crossmatched.

3:25 PM Safety and Security; Please see OR block

Intraoperative Care

5:30 PM - To PACU
- Monitor vital signs
every 15 minutes for 1
hour, vital signs every
30 minutes for the 2nd
hour, vital signs every 1
hour
- Oxygen support at 4 to
 5 liters per minute via
face mask
- Nothing by mouth for
now
- IVF: D5LR 1L x 80 cc
per hour
- IVFTF: PNSS 1L x 60
cc per hour
- D/C blood transfusion
line

THERAPEUTICS:
● Keterolac 30 mg TIV
every 6 hours x 4
doses; 1st dose at 9
pm, negative for skin
test
● Paracetamol 1000 mg
TIV every 6 hours x 3
doses; 1st dose at 10
pm
● Metaclopromide 10
mg TIV every 8 hours
as needed for nausea
or vomiting
- WOF: Hypotension,
tachycardia,
somnolence, oliguria,
hypopnea, refer
accordingly.

5:45 PM Postoperative D: Received patient from OR

S/P Exlap Salpingectomy under
SAB, with IVF, with IFC,
post-operative dressing dry and
intact, with bromage scale grade
 IV.

A: Vital signs taken and record

Placed side rails up for safety
Kept warm and thermoregulated
Input and output monitored
closely
Monitored for signs of bleeding
needs attended
*endorsed to the next shift for
continuity of care

7:00 PM - To RR
- Vital signs every 15
minutes for 1 hour then
every 1 hour
- IVF to confide
- Soft diet after 6 hours
post-operation

ORAL MEDICATIONS:
● Ascorbic acid 500 mg,
1 tablet, once a day
● FeSO4, twice a day
● Celecoxib 20 mg, 1
tablet every 12 for pain
- Daily perineal care
- For FP counseling
- Secure abdominal
binder
- IFC removal 24 hours
post-op, once with
adequate and clear
urine greater than 30
cc per hour
- COD on Postoperative
 Day 2
- referral

7:00 PM Postoperative Care D: Received patient from

recovery room S/P Exlap
Salpingectomy under SAB, with
IVF, with IFC, with bromage
scale still grade IV

A: Initial vital signs taken, kept

thermoregulated and kept side
rails up or encourage patient
verbalization. Patient moves
both extremities, due to
medication given.
Patient was transferred to the
ward as ordered.

R: Endorsed to ward for

continuity of care

10:30 PM - May transfer to ward

- Continue present
management
- Refer.

9/09/23 - Diet as tolerated,

7:00 AM increase oral fluid
- Continue present
medications and
management
- Vital signs every 4
hours and record
- Encourage early
ambulation
- Input and output every
 shift
- COD on Postoperative
Day 2
- Refa.

7:00 AM Continuity of care Continue monitoring the

patient and present oral
medications and management
IX. DRUG STUDY

Drug Name/ ACTION INDICATIONS CONTRAINDICATI SIDE EFFECTS NURSING

Classification ONS CONSIDERATION

• Interferes with • Hypersensitivity to

CEFAZOLIN bacterial cell wall • Genital infections Cephalosporins or • CNS – Headache, • Tell patient to
synthesis causing caused by E. coli, Penicillins lethargy, confusion, report reduced
cells to rupture and Klebsiella species, hemiparesis, urinary output,
die. P. mirabilis, and paresthesia, persistent diarrhea,
strains of syncope, seizures bruising or bleeding
Pharmacologic enterococci
class: • CV – • Instruct patient to
First-generation Hypotension, take medications
cephalosporin palpitations, chest exactly as
pain, vasodilation prescribed and to
Dosages/Route/ complete courses
• GI – Nausea, or therapy even
Frequency: vomiting, diarrhea, when she feels
Therapeutic class: abdominal cramps better.
Anti-infective 2g, IV LD an hour
prior procedure • Hematologic- • As appropriate,
lymphocytosis, review all other
bleeding tendency, significant and
hemolytic anemia, life-threatening
neutropenia, adverse reaction,
Pregnancy risk thrombocytopenia especially those
category B related to the
• Hepatic- hepatic drugs, tests, and
failure, behaviors
 hepatomegaly mentioned.

Others: Arthralgia,
dyspnea, urticaria,
chills, fever,
superinfections

Drug Name/ ACTION INDICATIONS CONTRAINDICATI SIDE EFFECTS NURSING

Classification ONS CONSIDERATION

• Initially, 30 mg IV • Hypersensitivity to
KETOROLAC • Interferes with or 60mg IM as a drug, its • CNS- drowsiness, • Inform patient that
prostaglandin single dose / 30mg components, headache, the drug is meant
biosynthesis by IM or IV q 6 hours aspirin or other dizziness only for short-term
inhibiting not to exceed NSAIDs. pain management.
cyclooxygenase 120mg/day • CV: hypertension
Pharmacologic pathway of • GI bleeding or • Tell patient to
class: arachidonic acid preforation • EENT: tinnitus immediately report
metabolism; also bleeding and
Nonsteroidal acts as potent • Advance renal • GI: nausea, adverse CNS
anti-inflammatory inhibitor of platelet Dosage/Route/ impairment, risk of vomiting, diarrhea, reactions.
drug (NSAID) aggregation. renal failure constipation
Frequency: 30mg, • Advise patient to
Therapeutic class: IV, ×4 doses ANST • Prophylactic use • Hematologic: minimize GI upset
Analgesic, (-) before surgery, Thrombocytopenia by eating small,
antipyretic, intraoperative use frequent servings of
anti-inflammatory when hemostasis is • Skin: rash, healthy food.
critical pruritus,
diaphoresis • Instruct to avoid
• Increase risk of aspirin products &
• Other: excessive herbs during
Pregnancy risk bleeding thirst, edema therapy.
st
category C (1 &
nd rd
2 trim), D (3
trim)

Drug Name/ ACTION INDICATIONS CONTRAINDICATI SIDE EFFECTS NURSING

Classification ONS CONSIDERATION

• Thought to • Drugs can cause • CNS: Agitation • Many OTC and

Paracetamol • Mild to moderate produce analgesia acute liver failure. (I.V), anxiety, prescription
pain; mild to by inhibiting Most cases of liver fatigue, headache, products contain
moderate pain with prostaglandin and injury are insomnia, pyrexia. acetaminophen; be
adjunctive opioids other substances associated with aware of this when
analgesics; fever that sensitize pain drug doses calculating total
Therapeutic receptors. Drugs exceeding 4,000 daily dose.
Class: Analgesics may relieve fever mg/day and often
through central involve more than • Use caution when
Pharmacologic action in the one prescribing,
Class: Dosage: 1,000 mg hypothalamic acetaminophen-con preparing, and
Para-aminophenol heat-regulating taining product. administering I.V.
derivatives Route: I.V center. acetaminophen to
avoid dosing errors
Frequency: Every leading to
6 hours accidental
overdose and
 Times 3 doses death.

Be careful not to
confuse dose in
milligrams and
dose in milliliters.

Drug Name/ ACTION INDICATIONS CONTRAINDICATI SIDE EFFECTS NURSING

Classification ONS CONSIDERATION

• Stimulates motility • CNS: Anxiety, • Monitor bowel

Metoclopramide • To prevent or of upper GI tract, • Contraindicated in drowsiness, sounds.
reduce increases lower patients for whom dystonic reactions,
postoperative esophageal stimulation of GI fatigue, lassitude, • Safety and
nausea and sphincter tone, and motility might be restlessness, effectiveness of the
vomiting blocks dopamine dangerous (those seizures, suicidal drug have not been
Therapeutic receptors at the with hemorrhage, ideation, confusion, established for
Class: • To facilitate chemoreceptor obstruction, or depression, therapy lasting
small-bowel trigger zone. perforation). dizziness, fever, longer than 12
GI stimulants intubation hallucinations, weeks.
• Drugs can cause headache,
irreversible tardive insomnia. • Monitor patient for
dyskinesia, even fever, CNS
Pharmacologic Dosage: 10 mg after the drug is symptoms, irregular
class: stopped. Risk pulse, cardiac
Route: I.V increases with arrhythmias, or
Dopamine duration of therapy abnormal BP which
Frequency: Every and total
antagonist 8 hours, PRN cumulative dose; may indicate NMS.
there is no
treatment. • Monitor patient for
dizziness,
headache, or
nervousness after
metoclopromide is
stopped; these may
indicate withdrawal.

Drug Name/ ACTION INDICATION CONTRAINDICATI SIDE EFFECTS NURSING

Classification ON CONSIDERATION

• Ascorbic Acid is • Gastrointestinal • Assess the

Ascorbic Acid • Postoperative • Its primary action generally upset, such as patient's dietary
wound healing includes acting as a considered safe stomach cramps or intake of vitamin C
cofactor for when used within diarrhea, especially and any signs of
enzymes involved recommended when taken in high deficiency.
Drug Class: in collagen doses. However, it doses.
Vitamin, Dosage: 500 mg synthesis, which is may be • Administer the
Water-soluble crucial for wound contraindicated in • Allergic reactions medication
vitamin, Antioxidant Route: P.O healing, connective individuals with a in rare cases, according to the
tissue formation, known characterized by prescribed dosage
Frequency: 1 tab and the health of hypersensitivity or symptoms like rash, and route.
OD skin, blood vessels, allergy to ascorbic itching, swelling, or
and bones. acid. difficulty breathing. • Monitor for any
signs of adverse
• Serves as a reactions,
potent antioxidant, especially
neutralizing harmful gastrointestinal
free radicals and discomfort.
protecting cells and
 tissues from • Educate the
oxidative damage. patient on the
importance of
• Additionally, it taking the
supports the medication as
immune system by directed and any
promoting the potential side
production and effects.
function of white
blood cells and
antibodies.

Drug Name/ ACTION INDICATION CONTRAINDICATI SIDE EFFECTS NURSING

Classification ON CONSIDERATION

• Elevates the • Allergy to any

FERROUS serum iron • Prevention and ingredient; sulphite • CNS – CNS • Warn patient that
SULFATE concentration, and treatment of iron allergy, toxicity, acidosis stool may be dark /
is then converted to deficiency anemias hemochromatosis, green
Hgb or trapped in hemosiderosis, • GI – GI upset,
the • Dietary haemolytic anemias anorexia, nausea, • Arrange for
reticuloendothelial supplement for iron vomiting, periodic monitoring
Pharmacologic cells for storage constipation, of Hct & Hgb levels
class: Hematinics and eventual • unlabeled use: diarrhea, dark
conversion to a supplemental use stools, temporary
usable form of iron. during epoetin staining of teeth
Therapeutic class: therapy to ensure
Iron supplements proper hematologic (liquid preparation) • Report severe GI
response to epoetin upset, lethargy,
rapid respirations,
• Patient’s actual and constipation
indication: Ferrous
Pregnancy risk sulfate is given to • Document and
category A the patient for the record
prevention and
treatment of iron
deficiency anemia
brought by her
condition.

Drug Name/ ACTION INDICATION CONTRAINDICATI SIDE EFFECTS NURSING

Classification ON CONSIDERATION

Exhibits
CELECOXIB anti-inflammatory, • Ankylosing •Hypersensitivity to • CNS- dizziness, • Advise patient to
analgesic and spondylitis, drug, sulfonamides, headache, immediately report
antipyretic action osteoarthritis or other NSAIDs. insomnia, fatigue bloody stools,
due to inhibitors of vomiting of blood or
COX-2 enzyme. • CV- Angina, signs/symptoms of
Pharmacologic tachycardia, renal damage
class: Nonsteroidal • advanced renal myocardial (nausea, fatigue,
cyclooxygenase – 2 Dosage/Route/Fre disease severe infarction lethargy, yellowish
(COX-2) inhibitor, quency: hepatic impairment, eye or skin,
NSAID sensitivity • EENT- rhinitis, tenderness in upper
200mg 1 tab, per precipitated by tinnitus, sinusitis, right abdomen,
orem, q 12 for pain aspirin. ophthalmic effects etc.)

• GI- nausea,
Therapeutic class: diarrhea, • Take drug with
Antirheumatic constipation food or milk

• GU- renal failure, • Avoid aspirin and

menorrhagia other NSAIDs
(ibuprofen,
• Hematologic – naproxen) during
bone marrow therapy
depression,
Pregnancy risk leukopenia
category C
• Respiratory -
upper respiratory
tract infection

• Skin - rash
 X. NCP

NCP #1
ASSESSMENT NURSING PLANNING NURSING RATIONALE EVALUATION
DIAGNOSIS INTERVENTION

Acute pain related Relieve the

Subjective: to distention or patient’s pain and • Administer pain • Prompt pain • After 30 minutes
rupture of the discomfort. medication as medication of nursing
“Habang nagluluto fallopian tube. prescribed by the administration is interventions, the
ako bigla akong physician. Consider crucial for effective patient’s pain has
nakaramdam ng Short Term: medications like pain relief. eased as
kirot sa likuran, non-opioid evidenced by 2/10
bandang baba, • Reduce pain to analgesics (e.g., • Close monitoring from 6/10 pain
tapos sa tyan ko.” level of 2/10 or acetaminophen) is essential to scale.
as verbalized by lower within based on the detect and address
patient. physician’s order any deterioration in • Goal met.
Long Term: and the patient’s the patient’s
condition. condition.
• Maintain pain
relief and prevent • Monitor vital signs • Timely reporting
Objectives: complications closely, especially can facilitate
throughout blood pressure and prompt
Vital Signs: hospitalization. heart rate, to detect interventions and
any signs of prevent
BP: 110/70 mmHg • The patient will be worsening complications.
monitored for signs condition.
PR: 78 bpm of implications such
as shock or • Educate the
RR: 20 cpm infection. patient about the
importance of
T: 36.2 ℃ reporting changes
in pain intensity or
Pain Scale: 6/10 location promptly.
NCP #2
ASSESSMENT NURSING PLANNING NURSING RATIONALE EVALUATION
DIAGNOSIS INTERVENTION

Objective: Risk for shock

related to excessive • After 30 minutes • Establish rapport • To gain the • After 30 minutes
BP: 110/70 mmHg blood loss of nursing patient’s trust. of nursing
secondary ectopic intervention, the • Monitor vital signs intervention, the
PR: 78 bpm pregnancy as patient’s bleeding • To provide patient displayed
evidenced by will cease, and will • Monitor I and O baseline data and hemodynamic
RR: 20 cpm vaginal bleeding. exhibit stable blood monitor the current stability as
flow and maintain • Ensure the patient well-being of the evidenced by vital
Temp: 36.2 ℃ normal vital signs. is comfortable in patient. signs within the
bed by positioning normal range.
(+) Vaginal her in supine • To prevent
bleeding, 2 pads position. dehydration, fluid • Goal met.
fully soaked. retention, and other
• Administer IV fluid problems related to
(D5LR) as fluid imbalance.
prescribed by the
physician. • To promote
adequate sleep and
• Carry out blood rest.
typing and cross
matching. • To replace water
and electrolyte loss
• Ensure a patent after significant
IV line. blood loss.

• To determine the
patient’s blood
 group and Rh
group to prepare for
possible blood
transfusion.

• To allow the
treatment to flow
directly into the
patient’s vein,
avoiding any clots
and other
complications.

NCP #3
ASSESSMENT NURSING PLANNING NURSING RATIONALE EVALUATION
DIAGNOSIS INTERVENTION

Subjective Knowledge deficit

regarding • After 30 minutes • Establish rapport • To gain the • Goal met as
“Bumisita po kami conditions related of nursing patients trust and evidenced by:
sa St. Gerard to unfamiliarity with interventions, the • Evaluate the have a good
General Hospital at diagnosis and patient will be able desire/ readiness of nurse-patient The patient
niresetahan po ako treatment. to verbalize the patient to learn. relationship. participated in the
ng gamot para sa understanding of learning process
pitong araw pero her therapeutic • Provide an • To determine the and were able to
tatlong araw lang needs. atmosphere of amount of verbalize their
po ako uminom respect, openness, important understanding on
dahil po trust, and information to the importance of
nakakaranas na collaboration. provide at any taking medications
ako ng dinudugo.” given moment. in the said time and
as verbalized by • Assess motivation day.
the client. and willingness of • It is important for
the patient to the patients with
caregivers. different values and
beliefs about health
• Discuss the and illness to feel
patient's perception welcomed and
of need. understood, it will
help them to take in
• State objectives information that
clearly in the does not align with
learner's term. their beliefs.

• Some patients are

ready to learn as
soon as they are
diagnosed, while
others cope better
by denying or
delaying the need
for instruction.

• Relate information
to the patient's
personal needs,
values or beliefs.

• To meet the
learner’s need
according to their
level of
understanding.
XI. DISCHARGE PLANNING

MEDICATIONS

● Remind the patient to take:

- Ferrous Sulfate 500mg 1 tablet each day for 6 months preferably before bed time
- Co-amoxiclav 500mg 2 times a day for seven days every 12 hours, 1 tablet 7AM and 1 tab in 7PM, do not take with empty
stomach
- Ibuprofen 500mg 1 tab for 3 days for pain only

● Describe the importance or regularly taking of prescribed medications including the potential unpleasant effects of non
compliance.

● Advice the client not to miss the intake of medications given by her physician upon discharge.

ENVIRONMENT AND EXERCISE

● Do light exercises like stretching or walking slowly and carefully; seek assistance for safety measures.

● Encourage the mother to keep the environment clean, quite and conducive to health for her rapid recovery and to avoid
infection

TREATMENT

● Continue home medications.

● Emphasize to the mother the importance of regular follow-up check-ups.

 ● Advise the mother to seek medical advice if any strange arises.

● Encourage the mother to let her be monitored by the health care provider until complete recovery is met.

HEALTH TEACHING

● Emphasize to the mother the importance of proper hand washing and proper hygiene.

● Refrain from sexual intercourse for at least 6 weeks until the follow-up appointment with the physician.

● Educate the client to recognize some signs and symptoms of pregnancy if it occurs, aside from the absence of menstrual
period and morning sickness she should visit her OB or nearest health center for proper assessment & check-ups.

● Advice the client to engage in safe sexual practices like proper hygiene before intercourse to prevent STDs and pelvic
infections that could cause further damage to the fallopian tubes.

OUT-PATIENT

● Remind the mother that even though she feels better, it is important to have the doctor monitor her progress. The patient is
scheduled for her follow up check up one week after her discharge from the hospital in the Out-Patient Department in
Valenzuela Medical Center (VMC) to evaluate her recovery.

DIET

● Encourage the patient to eat nutritious food and drink natural fruit juices for fast recovery.

● Get plenty of rest. Increase fluid intake. Keep the incision clean.

SPIRITUAL

● Encourage the mother to continue to seek God’s guidance and to continue to have a positive outlook in life.
● Emphasize the importance of prayers in healing and encourage to pray for her fast recovery.

● Refer the patient for spiritual counseling.

REFERENCES

● Tulandi, Barbieri , & Chakrabarti. (n.d.). Tubal Pregnancy. Retrieved September 15, 2023, from
https://www.uptodate.com/contents/ectopic-tubal-pregnancy-beyond-the-basics/print
● Professional, C. C. M. (n.d.). Ectopic Pregnancy. Retrieved September 15, 2023, from
https://my.clevelandclinic.org/health/diseases/9687-ectopic-pregnancy
● Ectopic Pregnancy. (n.d.). Retrieved September 15, 2023, from
https://www.marchofdimes.org/find-support/topics/miscarriage-loss-grief/ectopic-pregnancy#:~:text=Without%20trea
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ix%2C%20and%20the%20fundus.
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