The nurse has reviewed the Graphic Record and Diagnostic Results at 1030 The nurse is collaborating with another nurse about the client's plan of care. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Management of a client with suspected ectopic pregnancy is based on clinical findings such as delayed menses, unilateral abdominal pain, vaginal spotting, and abnormal pregnancy hormone levels. Ectopic pregnancy occurs when implantation happens outside the uterine cavity, most commonly in the fallopian tube, and can lead to rupture and life-threatening hemorrhage. Management includes medical therapy (methotrexate), diagnostic confirmation, and close monitoring of hCG trends. Interventions that are appropriate for intrauterine pregnancy (such as cerclage) are contraindicated. Rationale: • Methotrexate is a folic acid antagonist used to medically manage ectopic pregnancy by stopping rapidly dividing trophoblastic tissue. It prevents further growth of the ectopic implantation and allows the body to reabsorb the tissue. The client’s stable vital signs and early diagnosis make them a candidate for medical management. This is a standard and expected treatment for non-ruptured ectopic pregnancy. • Blood typing is essential in any suspected ectopic pregnancy because of the risk of hemorrhage and possible need for transfusion. Determining Rh status is also critical to guide administration of Rh immune globulin if the client is Rh-negative. Baseline blood typing ensures preparedness for emergency intervention. Therefore, this is a necessary diagnostic step. • Transvaginal ultrasound is the primary diagnostic tool used to confirm the location of pregnancy and rule out intrauterine gestation. It helps identify ectopic implantation in the fallopian tube or other abnormal sites. This imaging is essential for confirming diagnosis and guiding treatment decisions. • Serial β-hCG measurements are used to assess pregnancy viability and progression. In ectopic pregnancy, hCG levels often rise abnormally or plateau instead of doubling appropriately. Monitoring trends helps evaluate response to treatment such as methotrexate. Therefore, repeat testing is a critical component of ongoing management. • Cervical cerclage is used to treat cervical insufficiency in cases of intrauterine pregnancy to prevent preterm birth. It is not indicated in ectopic pregnancy because the pregnancy is not located within the uterus. Performing cerclage in this case would be inappropriate and provide no benefit. Therefore, it is contraindicated.