Acute Pain related to Ectopic Pregnancy
Ectopic Pregnancy is a common, life threatening condition that is the leading cause of death in early pregnancy. It affects 1 in 80 pregnancies in the UK and women who suffer have to face the physical trauma of major invasive treatment, their own mortality, the impact on their future fertility and the sad loss of losing their baby all very quickly. This can be a very frightening and distressing experience.
Occasionally, an ectopic pregnancy doesn't cause any noticeable symptoms and is only detected during routine pregnancy testing. However, most women do have symptoms, and these usually become apparent between week 5 and week 14 of pregnancy.
They include:
- abnormal vaginal bleeding
- abdominal pain, typically just in one side, which can range from mild to severe
- an absent period (amenorrhoea), and other symptoms of pregnancy
Nursing Diagnosis |
Goal and Expected Outcomes |
Intervention |
Acute Pain
Definition:
An unpleasant sensory and emotional experience arising in actual or potential tissue damage or described the existence of damage (International Association of Pain Study): a sudden attack or slowly in intensity from mild to severe that can be anticipated with a predictable end and with a duration of less than 6 months.
Defining characteristics:
- Reports verbally or non-verbally.
- The fact of observation.
- Antalgic position to avoid pain.
- Movement protect.
- Cautious behavior.
- Sleep disorders (glazed eyes, looked tired, difficult or chaotic motion, grinning).
- Focused on self-own.
- Focus narrowed (decreased perception of time, damage the process of thinking, decreased interaction with people and the environment).
- Behavioral distraction, for example: a walk, meet other people and / or activity, repetitive activity).
- Autonomic responses (such as diaphoresis, changes in blood pressure, changes in breathing, pulse and dilated pupils).
- Autonomic changes in muscle tone (perhaps in the range from weak to stiff).
- Expressive behavior (eg, restlessness, moaning, crying, alert, irritable, deep breaths / lamented).
- Changes in appetite and drinking.
Related factors:
- Agent injury (biological, chemical, physical, psychological)
| NOC:
- Pain Level,
- Pain control,
- Comfort level
Goal :
After the provision of nursing care within 2x24 hours clients reported reduced pain.
Expected outcomes:
- Being able to control the pain (know the cause of pain, able to use nonpharmacological techniques to reduce pain, seek help).
- Reported that pain was reduced by using a pain management.
- Being able to recognize pain (scale, intensity, frequency, and signs of pain).
- Stating a sense of comfort after the pain has subsided.
- Vital signs within normal range.
| Pain Management
- Perform a comprehensive pain assessment, including the location, characteristics, duration, frequency, quality factor and precipitation.
- Observation of nonverbal reactions of discomfort.
- Use therapeutic communication techniques to determine the patient's pain experience.
- Assess culture affects pain response.
- Assess the type and source of pain to determine interventions.
- Evaluation of past painful experiences.
- Evaluation together with patients and other health care team about the ineffectiveness of past pain control.
- Control environment that can affect pain as room temperature, lighting and noise.
- Help the patient and family to seek and find support.
- Teach about non-pharmacological techniques.
- Increase break.
- Reduce pain precipitation factor.
- Select and do pain management (pharmacological, non-pharmacological and interpersonal).
- Give analgesics to relieve pain.
- Collaborate with the doctor if any complaints of pain and unsuccessful action.
- Monitor patient acceptance of pain management.
Analgesic Administration
- Determine the location, characteristics, quality, and degree of pain before treatment.
- Check the doctor's instructions about the type of drug, dosage, and frequency.
- Check the history of allergy.
- Select the required analgesics or combinations of analgesics when giving more than one.
- Determine analgesic choice depending on the type and severity of pain.
- Determine analgesic choice, route of administration, and the optimal dose.
- Select the route of administration by IV, IM for pain medication regularly.
- Monitor vital signs before and after administration of the first analgesic.
- Provide timely analgesic, especially when severe pain.
- Evaluation of the effectiveness of analgesics, signs and symptoms (side effects).
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