The reported incidence of ectopic pregnancy in the United States has risen steadily over the past two decades.Causes include the increase in STDs accompanied by tubal infection and damage.The popularity of contraceptive devices such as the IUD has also increased the risk for ectopic pregnancy.The nurse who suspects that a patient has early signs of ectopic pregnancy should be observing her for symptoms such as: (Select all that apply.)

Question

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A missed period or spotting can easily be mistaken by the patient as early signs of pregnancy.More subtle signs depend on exactly where the implantation occurs.The nurse must be thorough in her assessment because pain is not a normal symptom of early pregnancy.As the fallopian tube tears open and the embryo is expelled,the patient often exhibits severe pain accompanied by intra-abdominal hemorrhage.This may progress to hypovolemic shock with minimal or even no external bleeding.In about half of women,shoulder and neck pain results from irritation of the diaphragm from the hemorrhage.

The Reported Incidence of Ectopic Pregnancy in the United States