Monitor for evidence of hemorrhage such as vital signs, abdominal pain, uterine status, and vaginal bleedin
Remember to assess the BP, check if the patient is bleeding profusely, and make sure to notify the doctor immediately.
Start intravenous (IV) infusion with an 18-gauge intracatheter as ordered.
Teach deep breathing techniques to alleviate the pain. Use diversional activities if possible.
Check for abdominal pain, assess the abdominal area for signs of internal bleeding(e.g. Cullen’s)
If nausea and vomiting are present, make sure the patient would not aspirate it.
Prepare for surgery according to preoperative protocol, and type and cross match 2 to 4 units of blood as ordered.
Postoperative IV infusions with oxytocin added are usually continued initially to facilitate uterine contractions and decrease uterine bleeding.
After D&C patient is at risk for infection. Make sure the patient has a good perineal hygiene.
Assess for indicators of infection by checking temperature every 4 hours and assessing vaginal discharge for a foul odor.
Monitor laboratory data especially white blood cell count.
Administer all medications as ordered. Observe the 10 Rs
Do not massage a boggy uterus if ovaries are enlarged since it can cause ovarian rupture.
Remember that this might very hard for the patient to accept, make sure to provide emotional support. Explain to the patient that it is not her fault this happened.
Discuss the family planning methods available for her. Remember to reiterate the importance ofmonitoring the hCG level and follow-ups.
