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Ms. C is being discharged after treatment for a hydatidiform mole. The nurse should include which of the following in the discharge teaching plan?
a. Do not become pregnant for at least one year.
b. Have blood pressure checked weekly for six months.
c. RhoGAM must be received with next pregnancy and delivery
d. An amniocentesis can detect a recurrence of this disorder in the future.
Correct Answer: A. The follow-up protocol of critical importance after a molar pregnancy is the assessment of serum chorionic gonadotropin (hCG); hCG is considered a highly specific tumor marker for gestational trophoblastic disease (GTD). The hCG levels are assayed at intervals for one year; a rise or plateau necessitates further diagnostic assessment and usually treatment. Pregnancy would obscure the evidence of choriocarcinoma by the normal secretion of hCG.
d. An amniocentesis can detect a recurrence of this disorder in the future.
Correct Answer: A. The follow-up protocol of critical importance after a molar pregnancy is the assessment of serum chorionic gonadotropin (hCG); hCG is considered a highly specific tumor marker for gestational trophoblastic disease (GTD). The hCG levels are assayed at intervals for one year; a rise or plateau necessitates further diagnostic assessment and usually treatment. Pregnancy would obscure the evidence of choriocarcinoma by the normal secretion of hCG.
Pregnancy-induced hypertension (PIH) may be seen earlier than the usual 20 weeks of gestation when there is a molar pregnancy; after evacuation of the mole there is no need for long-term blood pressure assessment.
The administration of RhoGAM is indicated to prevent hemolytic disease of the newborn as seen in a Rh-negative pregnancy.
In a molar pregnancy, cell differentiation is halted and trophoblastic tissue proliferates; the disorder becomes evident in the first trimester. An amniocentesis, usually performed at 16+ weeks of pregnancy, is not related to this disorder.
Posted in: MCN NCLEX
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