Xacc/280 Week 5 Patient Interview Questions

• Discuss the questions that would be important to include when interviewing a patient with this issue. Questions that increase the patient risk of developing an ectopic pregnancy should be asked and they include: history of previous tubal surgery, previous ectopic pregnancy, in utero diethylstilbestrol exposure, previous genital infections, infertility, current smoking, and previous intrauterine device use (Lozeau, & Potter, 2005). Questions about menstrual cycles as well as the pelvic pain should be inquired. The PQRST mnemonic guide can be used for a complete pelvic pain history as follows: P3 – Positional, palliating, and provoking factors; Q – Quality; R3 – Region, radiation, referral; S – Severity; T3 – Temporal factors (time and mode of onset,
Depending on the type of ectopic pregnancy, the patient treatment may include medical management with methotrexate, or surgery. Methotrexate is an established medical treatment for unruptured ectopic pregnancy and it is preferred over surgical therapy because it is less invasive and less expensive. The patients must be counseled about the possibility of treatment failure, and the associated side effects of methotrexate which include bone marrow suppression, elevated liver enzymes, rash, alopecia, stomatitis, nausea, and diarrhea. The patient should also be counseled on the time to resolution of the ectopic pregnancy which is three to seven weeks after methotrexate therapy. Follow-ups with methotrexate treatment require weekly and sometimes daily measurement of β-hCG until the levels become undetectable. If the levels fail to decline, the patient can be treated with a second course of methotrexate. Surgical intervention is required if ruptured ectopic pregnancy is suspected, or if β-hCG increases. The surgical procedures include salpingostomy and salpingectomy (Lozeau, & Potter,