Reference no: EM132956750

Mrs. Jones, a 31-year-old female, presents to the emergency room with sudden pain radiating from her mid abdomen to her right shoulder. The patient reports that she is also experiencing light vaginal bleeding. Upon questioning, the nurse finds out the patient has an IUD and that she missed her last period. The patient is currently sexually active with multiple partners as well. What is the first test the nurse should do on this patient? What should the nurse be concerned about at this time? The nurse starts an IV and draws blood work. The doctor orders morphine 2 mg IV q4h PRN moderate to severe pain, and an abdominal ultrasound. The RN administers the morphine per orders and the LPN prepares the patient for an ultrasound by giving a prescribed IV fluid bolus of 1 L Normal Saline for bladder filling. The UAP assists the patient to provide a urine sample, which is used for a point-of-care HCG urine pregnancy test which comes back positive. The UAP and patient report to the nurse that there was more bleeding when she went to the bathroom and the patient is complaining of some upper shoulder pain now. What should the nurse be concerned about at this time? The nurse notifies the doctor who orders an abdominal ultrasound, which shows a tubal rupture. The patient is rushed to surgery. When the patient returns from surgery, the nurse assesses the patient. Vital signs are stable at this time, the patient is alert and oriented to person, place, time and situation (a little groggy), and the nurse notes no signs or symptoms of distress. While the patient was off the unit, the complete blood count comes back and the hemoglobin is 6.2. The type and screen also result and shows the patient is blood type O and rH factor negative. Why would the patient have a low hemoglobin with only light vaginal bleeding? What else should the nurse ensure is administered to this patient