ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: • Acute pain • Ectopic • After 8 hours Independent: • After 8

“Masakit ang related to pregnancy of nursing • Monitor • To determine hours of
tiyan ko” (My distention or is gestation interventions maternal presence of nursing
tummy hurts) as rupture of , the patient vital signs. hypotension intervention
located
verbalized by fallopian tube will be and tachycardia s, the
outside the
patient. relieved or caused by patient was
uterine controlled relieved or
rupture or
Objective: cavity. The hemorrhage. controlled
• Facial mask fertilized
of pain. ovum • To further
• Monitor for
• Guarding implants assess the
presence and
behavior. outside of amount of vaginal present
the uterus, bleeding. situation
usually in indicating
the fallopian hemorrhage.
tube.
Predisposin • Monitor for • Increased pain
g factors increase and pain and abdominal
include and abdominal distention
adhesions distention and indicates
of the tube , rigidity. rupture and
possible
salpingitis,
intraabdominal
congenital hemorrhage.
and
developmen • To determine
tal • Monitor the amount of
anomalies complete blood loss.
of the blood count
(CBC).
fallopian
tube, • Promotes
• Provide comfort
previous relaxation and
ectopic measure like may enhance
pregnancy, back rubs, deep patient’s coping
use of an breathing. abilities by
intrauterine Instruct in refocusing
relaxation or attention.
device for
visualization
more than 2 exercises.
years, Provide
multiple diversional
induced activities.
abortions,
menstrual • Provide • Diversional
reflux , and diversional activities aids in
decreased activities. refocusing
tubal attention and
motility. enhancing
coping with
limitations.
Collaborative:
• To maintain
• Administer acceptable
analgesics as level of pain
indicated.