Therapeutic abortion may be done to safeguard the woman’s health, or a voluntary abortion may be a woman’s reproductive decision.
CLIENT ASSESSMENT DATA BASE
Circulation
Preexisting maternal health problems placing client at risk
Ego Integrity
Pregnancy often unplanned; may be result of incest/rape.
May express concern about decision and future expectations.
Possible feelings of abandonment, i.e., loss of contact with male partner.
Stress factors may include inadequate finances, cultural/religious conflicts, and individual plans for the future.
May have strong feelings/beliefs regarding abortion that may be in conflict with present situation (e.g., conception is result of incest or rape); lack of support, or family/other pressures to have abortion.
Food/Fluid
Severe nausea and vomiting
Safety
History of pelvic inflammatory disease, STDs, or exposure to contagious diseases, such as rubella
Exposure to toxic/teratogenic agents
Sexuality
Lack of, or inadequate use of, birth control measures.
Menstrual history may include problems such as endometriosis, heavy flow, or irregular periods.
Uterus may be in extreme flexion or version.
Absence of adnexal masses (rules out ectopic pregnancy).
Vaginal bleeding may be present.
Social Interaction
Possible lack of support systems or conflict within the family/couple.
Teaching/Learning
Family history of genetic conditions.
Client’s perception of reasons for pregnancy termination, influencing factors, and anticipated effects may/may not be clear; alternatives may not have been considered/discussed or explored.
DIAGNOSTIC STUDIES
Complete Blood Count (CBC), Blood Type, and Rh Determination: Identifies individual needs.
Urine or Radioimmunoassay of Serum for Human Chorionic Gonadotropin (HCG): Verifies pregnancy.
Papanicolaou Smear: Rules out dysplasias.
Gonorrheal Culture, Rapid Plasma Reagin (RPR): Determine presence of STD.
Ultrasonography: May be done to confirm the pregnancy, to date the pregnancy, or to localize the placenta, if there is some discrepancy between uterine size and estimated date of birth.
Genetic Testing/Screening: Identifies affected fetus, which may be reason for decision to terminate pregnancy.
NURSING PRIORITIES
1. Evaluate biopsychosocial status.
2. Promote/augment coping strategies.
3. Provide emotional support.
4. Prevent postprocedural complications.
5. Provide appropriate instruction/information.
DISCHARGE GOALS
1. Free of complications following procedure
2. Coping effectively with situation
3. Specific therapeutic needs and concerns understood
CLIENT ASSESSMENT DATA BASE
Circulation
Preexisting maternal health problems placing client at risk
Ego Integrity
Pregnancy often unplanned; may be result of incest/rape.
May express concern about decision and future expectations.
Possible feelings of abandonment, i.e., loss of contact with male partner.
Stress factors may include inadequate finances, cultural/religious conflicts, and individual plans for the future.
May have strong feelings/beliefs regarding abortion that may be in conflict with present situation (e.g., conception is result of incest or rape); lack of support, or family/other pressures to have abortion.
Food/Fluid
Severe nausea and vomiting
Safety
History of pelvic inflammatory disease, STDs, or exposure to contagious diseases, such as rubella
Exposure to toxic/teratogenic agents
Sexuality
Lack of, or inadequate use of, birth control measures.
Menstrual history may include problems such as endometriosis, heavy flow, or irregular periods.
Uterus may be in extreme flexion or version.
Absence of adnexal masses (rules out ectopic pregnancy).
Vaginal bleeding may be present.
Social Interaction
Possible lack of support systems or conflict within the family/couple.
Teaching/Learning
Family history of genetic conditions.
Client’s perception of reasons for pregnancy termination, influencing factors, and anticipated effects may/may not be clear; alternatives may not have been considered/discussed or explored.
DIAGNOSTIC STUDIES
Complete Blood Count (CBC), Blood Type, and Rh Determination: Identifies individual needs.
Urine or Radioimmunoassay of Serum for Human Chorionic Gonadotropin (HCG): Verifies pregnancy.
Papanicolaou Smear: Rules out dysplasias.
Gonorrheal Culture, Rapid Plasma Reagin (RPR): Determine presence of STD.
Ultrasonography: May be done to confirm the pregnancy, to date the pregnancy, or to localize the placenta, if there is some discrepancy between uterine size and estimated date of birth.
Genetic Testing/Screening: Identifies affected fetus, which may be reason for decision to terminate pregnancy.
NURSING PRIORITIES
1. Evaluate biopsychosocial status.
2. Promote/augment coping strategies.
3. Provide emotional support.
4. Prevent postprocedural complications.
5. Provide appropriate instruction/information.
DISCHARGE GOALS
1. Free of complications following procedure
2. Coping effectively with situation
3. Specific therapeutic needs and concerns understood
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