Page 97 - Critical Maternity & Newborn Health Nursing

Nursing Management of Bleeding in Early Pregnancy

I-Assessment

History

• Obtain a history of previous spontaneous abortion, multiple

therapeutic abortion, pelvic inflammatory disease or previous tubal

damage or ectopic pregnancy, current pregnancy confirmed, nausea

and vomiting, previous bleeding, coagulation problems,

contraceptive use, especially of an IUD .

• Obtain a history of onset, duration, amount, color, frequency,
recurrence and consistency of bleeding.

• Obtain a history regarding associated symptom, prior bleeding

episodes, and activity onset of bleeding (any predisposing factors)

Any associated pain:

• Type of pain (sharp, colicky, knifelike, stretching, cramp-like,

stabbing, dull aching).

• Site of pain: (where?)

• Time of pain: (before or after bleeding) .

• Uterine cramping or contractions.

Physical examination :

• Spotting or active bleeding (color, quantity, consistency).

• Relaxed or dilated cervix .

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