Nursing Interventions for Placenta Previa: Management Quiz and Flashcards

Study Notes

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

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)

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)

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

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

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

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