During the postanesthesia period the nurse must monitor patients for signs of shock, particularly if a rupture was present. After stabilization, nursing interventions promote comfort and counteract the effects of immobility. Nursing actions include prompt administration of analgesia, assistance with positioning and eventual ambulation, and encouraging use of incentive spirometry. Since the patient may have been significantly volume-depleted prior to surgery, IV fluids are usually continued and blood transfusions are possible. If the patient is Rh negative, a dose of RhoGAM is administered prior to discharge to avoid maternal-fetal blood incompatibilities in future pregnancies.
Some patients experience grief and feelings of guilt, anger, frustration, or failure.
These women need support, concern, and time to express their feelings and to validate their experiences of lost pregnancy. They may have questions related to the prognosis of future pregnancies and the answer must be clear, honest, and consistent. The expanded use of more conservative treatment modalities have dramatically reduced both maternal mortality and the need for radical surgery. Despite this, women with previous ectopic pregnancies are less fertile 7 and, after the first ectopic, at greater risk of a second extrauterine gestation. There are many choices and considerations to be made about future childbearing plans.