Nursing Care for a Patient with Ectopic Pregnancy and Shock : A Case Study.

Abstract

     This study is a case study aimed at providing nursing care for a patient with ectopic pregnancy complicated by shock. Data were collected through a review of the patient’s medical records regarding treatment, problem analysis, nursing care planning, implementation of nursing interventions, and evaluation of nursing outcomes. The process was guided by Gordon’s functional health patterns assessment and applied Orem’s nursing theory.

     Results: The case involved a 38-year-old Thai woman who presented at the outpatient obstetrics and gynecology clinic with complaints of right lower abdominal pain and fainting for 3 hours prior to hospital admission. Her last menstrual period (LMP) was January 25, 2024, and she had not used contraception. On initial examination, she had abdominal distension, right lower abdominal tenderness, suprapubic tenderness, pallor, sweating, cold extremities, and worsening abdominal pain. A pelvic examination revealed vaginal discharge mixed with blood. Transvaginal sonography (TVS) showed free fluid with clotted blood. The physician diagnosed ruptured ectopic pregnancy with hypovolemic shock and referred the patient to the emergency department for preparation and immediate exploratory laparotomy. The patient was provided with both physical and psychological preoperative preparation and underwent emergency surgery within 30 minutes. Postoperatively, she was admitted to the gynecology ward where she received holistic nursing care. Her condition gradually improved, and she was discharged upon medical approval after a total hospitalization period of 3 days. She was scheduled for follow-up within one week for suture removal and histopathological results.