Vaginal Bleeding in Pregnancy

Vaginal Bleeding in Pregnancy

Vaginal Bleeding in pregnancy:

A pregnant patient arrives in the Emergency Department with complaints of vaginal bleeding. You will choose the gestational age of your patient, and based on that gestational age answer the following questions: 2 References needed and at least 2 in text citation.

1. Knowing the gestational age, provide information on LMP, and EDD
2. What are the possible reasons she is bleeding at this gestational age?
3. What are your nursing interventions for this issue, and please include education to your patient.

SAMPLE ANSWER

Vaginal Bleeding in Pregnancy

The patient who is at her 10^th week of pregnancy as of October 9, 2019 is experiencing vaginal bleeding. During the assessment process, it is discovered that her last menstrual period began 10 weeks and three days ago; hence indicating she is in her 10^th week. The patient has been experiencing low-back pains, increase in vaginal discharge, contractions, as well as Braxton hicks. Mostly, she had signs of early pregnancy loss, which include bleeding and cramping.

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Some of the medical issues involved with bleeding and cramping during such an early stage include ectopic pregnancy or a miscarriage. According to the American College of Obstetricians and Gynecologists (2016), 10% of women who experience bleeding and cramping end up having a miscarriage. Other symptoms may include pelvic and abdominal pain, which at times occur even before one realizes they are pregnant. Various interventions can be used to ensure the patient does not have an ectopic pregnancy. First, for pregnancies between 9-12 weeks, a surgical intervention evacuation can be conducted to remove retained products of conception (Ward &Hisley, 2016). However, the patient should be educated on the risks involved with the procedure, such as hemorrhage, infections, and uterus perforation.

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Medical management can also be used as an intervention, whereby, treatment is given using anti-progestin to increase uterine contractions and block progesterone action. However, if the patient had an ectopic pregnancy, other interventions such as laparotomy and laparoscopy would be considered (Ward, &Hisley, 2016). The most preferable option is laparoscopy since its side effects are less and the patient has shorter hospital stays. However, the patient should be educated on the risks of this intervention, which may include incomplete removal of trophoblast tissue.

References

The American College of Obstetricians and Gynecologists. (2016, July). Women’s Health Care Physicians. Retrieved from https://www.acog.org/

Ward, S., &Hisley, S. (2016). Maternal-child nursing care: Optimizing outcomes for mothers, children, & families (2nd Ed.).

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