CHAPTER 14 Women’s Health^519
TREATMENTS
- Dilation and Curettage (D&C) to remove all trophoblastic cells.
- Frequent testing of hCG levels to ensure no further cells remain.
- Chest x-ray to assess for lung metastasis.
- Liver function tests to assess for liver metastasis.
- Contraception for a full year.
- Chemotherapy till hCG levels return to normal:
- methotrexate
- actinomycin-d
- Total abdominal hysterectomy and chemotherapy.
NURSING DIAGNOSES
- Risk of altered parenting
- Anticipatory grieving
- Powerlessness
NURSING INTERVENTIONS
- Educate the patient:
- Trophoblastic disease.
- Discuss further testing.
- Allow for grieving.
- Provide referrals to counselors, clergy.
- Discuss need for year-long birth control.
Pregnancy
Gestational age is measured from the first day of the last menstrual period (LMP).
At each prenatal visit, the fundus (the top of the uterus) will be measured as to its
location in the abdomen. This information is used to assess the growth of the
fetus. Pregnancy is usually divided into trimesters. The first trimester is from 0 to
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