fertilized ovum implants outside of the uterine cavity
-Risk factors are sexually transmitted infections, tubal damage or infection, intrauterine devices, and tubal surgeries.
-Clinical manifestations are lower-quadrant abdominal pain on one side, mild to moderate vaginal bleeding, and missed or delayed menses.
-Signs of subsequent hypovolemic (hemorrhagic) shock from tubal rupture include dizziness, hypotension, tachycardia, and decreased urinary output to <30 mL/hr.
-Blood that is irritating the diaphragm can cause referred shoulder pain which indicates intraabdominal bleeding .
-Peritoneal signs (eg, tenderness, rigidity, low-grade fever) develop subsequently.
The nurse should use a sterile glove during vaginal examination in the presence of ruptured membranes to prevent infection. Use of nonsterile gloves and instruments during vaginal examinations increases the risk of infection in the laboring client or fetus (eg, chorioamnionitis).
(Option 1) A nitrazine pH test strip inserted into the vagina can differentiate between amniotic fluid, which is alkaline, and vaginal fluid, which is acidic. A blue-green, blue-gray, or deep blue color indicates a positive result and probable rupture of membranes. A yellow, olive-yellow, or olive green color indicates a negative result and suggests that membranes are intact.
(Option 3) Leopold maneuvers help determine fetal presentation and involve systematic palpation of the client's abdomen. These maneuvers assist the nurse in locating the fetal back for optimal placement of the ultrasound transducer for external fetal heart monitoring.
(Option 4) Hospital policy, provider preference, and the client risk profile will dictate appropriate oral intake during labor. However, there is no evidence to support NPO status of low-risk laboring clients, and most clients benefit from hydration provided by oral clear liquids during labor.