Page 679 - Saunders Comprehensive Review For NCLEX-RN

pain, signs of shock

C. Interventions

1. Obtain assessment data and vital signs.
2. Monitor bleeding and initiate measures to prevent
rupture and shock.
3. Methotrexate, a folic acid antagonist, may be
prescribed to inhibit cell division in the developing
embryo.
4. Prepare the client for laparotomy and removal of the
pregnancy and tube, if necessary, or repair of the
tube.
5. Administer antibiotics; Rh (D) immune globulin is
o
prescribed for Rh-negative women.
VIII. Fetal Death in Utero

A. Description
1. Fetal death in utero refers to the death of a fetus after
the twentieth week of gestation and before birth.
2. The client can develop DIC if the dead fetus is retained
in the uterus for 3 to 4 weeks or longer.
B. Assessment
1. Absence of fetal movement
2. Absence of fetal heart tones
3. Maternal weight loss
4. Lack of fetal growth or decrease in fundal height
5. No evidence of fetal cardiac activity
6. Other characteristics suggestive of fetal death noted on
ultrasound
C. Interventions
1. Prepare for the birth of the fetus.
2. Support the client’s decision about labor, birth, and the
postpartum period.
3. Provide support and ask what can be helpful; provide
assistance as appropriate and requested.
4. Accept behaviors such as sadness, anger, and hostility
from the parents.
5. Refer the parents to an appropriate support group.

Cultural, spiritual, and religious practices and beliefs are

important to consider when caring for the parents of a fetus who has
died. Be aware of these cultural, spiritual, and religious practices and
beliefs and ensure that their beliefs are respected and implemented as
appropriate.
IX. Hepatitis B
A. Description

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