Question

A client who has undergone a dilation and curettage for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that vital signs are stable, bleeding has been controlled, and the woman has adequately recovered from the administration of anesthesia. To promote an optimal recovery, discharge teaching should include (Select all that apply):

a. Iron supplementation.

b. Resumption of intercourse at 6 weeks following the procedure.

c. Referral to a support group if necessary.

d. Expectation of heavy bleeding for at least 2 weeks.

e. Emphasizing the need for rest.

Answer 1

Optimal recovery after a dilation and curettage includes iron supplementation, waiting for the obstetrician's approval before resuming sexual intercourse, considering support groups, expecting normal lochia rather than heavy bleeding, and ensuring adequate rest.

Step-by-step explanation:

A client who has undergone a dilation and curettage (D&C) for early pregnancy loss is advised for optimal recovery post-procedure. The discharge teaching should include:

• Iron supplementation: To address potential anemia caused by bleeding.
• Resumption of sexual intercourse: Generally recommended to wait until 6 weeks post-procedure or upon advice of the obstetrician to allow time for healing and reduce infection risk.
• Referral to a support group, if necessary: Emotional and psychological support is vital for recovery after a pregnancy loss.
• Expectation of bleeding: Heavy bleeding for at least 2 weeks is not expected; normal postoperative discharge should not be excessively heavy. Patients should be advised to monitor for and report excessive bleeding.
• Emphasizing the need for rest: Rest is critical to recovery following any surgical intervention.

It is important to note that while uterine contractions after childbirth (in a process called involution) help to limit postpartum bleeding, women who have recently given birth or had a D&C should expect some vaginal discharge called lochia. Initial discharge will be heavier and then progresses to become lighter over time. Women should be encouraged to monitor the type and amount of their postoperative discharge, to help distinguish between normal recovery and signs of potential complications.