The graduate nurse (GN) is assisting the nurse preceptor to provide education to a client diagnosed with a molar pregnancy. Which statement by the GN requires the precepting nurse to intervene?

Question

The graduate nurse (GN) is assisting the nurse preceptor to provide education to a client diagnosed with a molar pregnancy.  Which statement by the GN requires the precepting nurse to intervene?

Quizplus · Accepted Answer

A molar pregnancy, or hydatidiform mole, is a type of gestational trophoblastic disease that results from abnormal fertilization. It causes rapidly growing trophoblastic tissue that is initially benign but may lead to gestational trophoblastic neoplasia (GTN) (eg, invasive mole, choriocarcinoma). If trophoblastic tissue continues to grow or metastasize after evacuation of a molar pregnancy, levels of human chorionic gonadotropin (hCG), a hormone that is also used to diagnose pregnancy, will continue to increase. Therefore, the nurse should emphasize the importance of avoiding pregnancy during follow-up care to allow health care providers to monitor for rising hCG levels, which may indicate malignant GTN (Option C). Weekly monitoring of hCG levels is required at first, followed by continued monitoring for 6-12 months postpartum. (Option A) Uterine evacuation is the recommended treatment option for a molar pregnancy because it is effective and reduces potential complications (eg, hemorrhage, retained trophoblastic tissue). (Option B) The nurse should help the client understand that the pregnancy was not viable, be available to process emotions with the client, and provide resources for coping with pregnancy loss. (Option D) Trophoblastic cells may contain genetic material that expresses the Rh factor. Therefore, Rh immune globulin (eg, Rhogam) is required for clients with Rh-negative blood types following a molar pregnancy. Educational objective: Following a molar pregnancy, the nurse should instruct the client to avoid pregnancy during follow-up care while health care providers are monitoring human chorionic gonadotropin levels to ensure that gestational trophoblastic neoplasia (eg, choriocarcinoma) does not develop.

The Graduate Nurse (GN) Is Assisting the Nurse Preceptor to Provide