13. Baseline fibrinogen( if bleeding is extensive, fibrinogen reserve may be used up in the body’s attempt to accomplish effective clot formation NO IE or rectal examination, no enema Keep IV open for possible blood transfusion May lead to couvelaire uterus (blood infiltrating the uterine musculature) forming a hard, board-like uterus without apparent bleeding FHT monitoring; VS monitorng Fetal distress (altered FHR) Oxygenation to limit fetal anoxia Abdomen is tender, painful, and tense (board-like) Keep woman in lateral (not supine) position Painful (sharp stabbing) vaginal bleeding
23. Gestational sac in tube in UTZ Visualization of pelvic organs through culdoscopy Presence of bloody fluid Administration of RHOGAM to Rh negative mothers Vaginal spotting or bleeding may be present Provide emotional support for the grieving process Rigid, tender abdomen on palpation Shock monitoring and management before and after surgery Unilateral LQ (abdominal or pelvic pain Prepare for surgery Amenorrhea with (+) PT
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29. Increased nausea and vomiting If there is no rise in HCG, further treatment (hysterectomy or chemotherapy) is required. No FHT Educate on the need to monitor HCG for 1 year (biweekly until low then monthly fr six months, then every two months for the next six months) Elevated HCG levels Educate on avoiding pregnancy for at least 1 year UTZ findings (no fetus) Mole is removed by vacuum aspiration or curettage Persistent bleeding (dark red/ brown vaginal fluid with passage of grapelike clusters Monitoring and management of shock by blood transfusion or IV therapy Uterus large for gestational age