Discharge And Home Healthcare Guidelines

PATIENT TEACHING. If the patient is receiving methotrexate on an outpatient basis, teach her that more severe pain may indicate treatment failure and that she needs to notify the physician. She should not drink alcohol or take vitamins containing folic acid. She may experience anorexia, nausea and vomiting, mouth ulcers, and sensitivity to sunlight as side effects of methotrexate. She also needs to follow up with scheduled hCG testing.

If a salpingectomy was done, explain to the patient that becoming pregnant again may be difficult. Fertilization takes place only on the side of the remaining tube after ovulation of the ovary on the same side. If a tubal repair was done, the patient is at a higher risk for a subsequent ectopic pregnancy, as well as infertility. Educate the patient to recognize the signs and symptoms of ectopic pregnancy and to notify the doctor immediately if these should occur.

To prevent recurrence, advise the patient to engage in safe sexual practices. Teach her strategies to avoid STDs and pelvic infections that could cause further damage to the fallopian tubes.

POSTOPERATIVE INSTRUCTIONS. Give the patient the following instructions: Limit activity and get plenty of rest. Increase fluid intake. Keep the incision clean. Refrain from sexual intercourse for 2 weeks until the follow-up appointment with the physician occurs. Delay pregnancy for at least 3 months to allow for tubal healing. Determine that she has a method of birth control prior to leaving the hospital.

REFERRAL. If the patient is having difficulty dealing with the perinatal loss, referring her to a support group is appropriate. Often, follow-up by the hospital perinatal grief counselor is done. Referral to a fertility specialist is indicated if she is having difficulty conceiving for 6 months after tubal surgery.

Pregnancy Guide

Pregnancy Guide

A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.

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