Placenta Previa Nursing Management Quiz

Placenta Previa Nursing Management

• Patient may not receive analgesics due to fetus' prematurity, resulting in intense labor pain
• Patient needs to identify and report signs of placenta previa (bleeding, cramping) immediately
• Assess for signs of infection
• Monitor for signs of hemorrhage and shock during postpartum period due to uterus' diminished ability to contract
• Discuss possibility of neonatal death with patient and family, emphasizing frequent monitoring and prompt management to reduce risk
• Encourage patient and family to verbalize feelings and develop effective coping strategies, referring for counseling if necessary

Placenta Previa Possible Complications

• Postpartum hemorrhage infection

Abruptio Placenta (Placental Abruption)

• Occurs when the placenta separates from the uterine wall prematurely, usually after the 20th week of gestation, producing hemorrhage
• Types of abruptio placenta: Revealed abruption (blood tracks between membranes and escapes through the vagina and cervix)

Complications of Abortion

• Infection (usually E. Coli)
• Sepsis (abortion complicated by infection)
• Isoimmunization (production of antibodies against Rh-positive blood)
• Powerlessness (sadness and grief over the loss or feeling of lost control)

Procedures Used in Pregnancy Termination

• Vacuum curettage (for 1st tri abortions to remove remaining products of conception)
• Dilatation and curettage (dilatation of the cervix followed by gentle scraping of the uterine walls to remove products of conception)

Nursing Diagnosis and Interventions

• Note amount, color, and odor of vaginal bleeding
• Place patient's bed in trendelenburg's position as ordered
• Assess vital signs and monitor urine output closely
• Provide good perineal care
• Check patient's blood type and provide emotional support and counseling
• Encourage patient and partner to express feelings and develop effective coping strategies
• Explain all procedures and treatments to the patient and provide teaching about aftercare and follow-up

Abortions and Placenta Previa Complications in the Third Trimester

• Placenta previa occurs when the placenta implants in the lower uterine segment, obstructing the internal cervical os and failing to provide as much nourishment as the fundus

Abruptio Placenta Nursing Management and Possible Complications

• Encourage patient and family to verbalize feelings and develop effective coping strategies, referring for counseling if necessary
• Maternal mortality; postpartum patients are at risk for vascular spasm, intravascular clotting or hemorrhage, and renal failure from shock
• Perinatal mortality; neonatal complications stem from hypoxia, prematurity, and anemia

Premature Rupture of Membranes (PROM)

• Rupture of the chorion and amnion 1 hour or more before the onset of labor
• Gestational age of the fetus and estimates of viability affect management
• Etiology: unknown, but associated with malpresentation, weak areas in the amnion and chorion, subclinical infection, and possibly incompetent cervix
• Pathophysiology: amniotic fluid gushing from the vagina; maternal fever, fetal tachycardia, and malodorous discharge may indicate infection
• Assessment findings: ferning is evident; nitrazine test tape turns a blue-green color