PlacentaPrevia

Introduction
Pregnancy
an exciting time in any parents life.
Why?
early consistent prenatal care
Early consistent prenatal care will result to decrease in
abnormalities
poor health
death
mortality
If theres no good prenatal care...
Complications
pre-existing maternal medical problems
from the pregnancy itself
Pregnancy
Placenta previa is experienced 1 out of 200 of pregnancies around the orld.
!aternal morbidity rate " #$
!ortality rate " less than 1$
Objectives
Student centered"
Present a comprehensive and detailed report regarding the patients illness.
%race the pathophysiology of placenta previa.
&nderstand the factors that might have contributed to the development of the
disease.
Provide organi'ed and structured nursing interventions as a response to the
patients anticipated needs.
Client centered:
(stablish rapport ith our client including her family members.
Perform physical assessment on clients condition so as to attain baseline data
)iscuss and explain the definition of the complete diagnosis that ould explain
the illness of our client.
*evie the anatomy and physiology of female reproductive systems.
)etermine the diagnostic tests our client has undergone including their
implication and nursing resposibilties.
Identify and prioriti'e the needs of our patient.
+ormulate an appropriate nursing care plan based on the assessment identified
needs and problem of the patient.
*ender health teaching as part of our holistic care to alleviate the problems
identified.
(valuate complications to nursing practice, education and research.
Patient Profile:
-ame" patient ./0
1ge" 22
3ex" +emale
4irthday" !arch 20, 1565
4irthplace" 4ayambang, Pangasinan
!arital 3tatus" !arried
7ccupation" 8ouseife
*eligion" *oman Catholic
1ddress" 4onifacio 3ur, 9lanera -.(
)ate 1dmitted" :anuary 2;, 2012
%ime 1dmitted" 11"00 am
1dmitting )iagnosis" P& 26 to 2< ee=s 17>, breech in labor >1P0, placenta
previa partialis
+inal )iagnosis" )elivered operatively to alive term baby boy breech >1P1
?1001@
1dmitting Physician" )r. )ela Cru'
7ther )iagnosis" 9CC3 I :anuary 2;, 2012
Consultant )octor" )r. )ela Cru'
1ttending Physician" )r. )ela Cru'
Nursing History
1. Chief Complaint
Came in with chief complaint of painless, moderate vaginal bleeding. Soaking
more than 1 pad in 3 hours.
4. 8istory Present Illness
+e hours P%1, patient experienced on and off vaginal bleeding painless
in character. 8ence admitted
C. Past !edical 8istory
&nremar=able
). +amily 8istory
?A@ 8P- " +ather side
?A@ 8P- " !other side
Obstetric Gynecology History
!enarche started" 11 years old, regular, usually lasts from ;-# days.
-o history of abortion noted.
9!P" !ay 2, 2011
()C " +ebruary 5, 2012
17> " 26 B 2< ee=s ?>1P0@
Physical Assessment
II. 9evel of consciousness
conscious and coherent. (present cues that she is conscious and coherent
like oriented to time and place, etc
III. 4ody parts
Anatomy and Physiology
Placenta
Cpanca=eD appearance
Its groth parallels that of the fetus, groing from fe identifiable cells at
the beginning of pregnancy
temporary organ reEuired for the development of the embryo and fetus
1# to 20 cm in diameter and 2 cm in depth
!! to "!! grams #$ lb%
Placenta Problems
!ost omen ill have no problems ith their placentas during pregnancy. %here
are a fe conditions, such as placenta previa, that mothers should be aare of.
&lassifications of placenta previa
1. %otal previa- the placenta completely covers the internal cervical os.
2. !arginal previa- the edge of the placenta lies at the margin of the internal
cervical os and maybe exposed during dilatation.
2. Partial previa- the placenta covers a part of the internal cervical os
;. 9o-lying placenta- the placenta is implanted in the loer uterine segment but
does not reach the internal os of the cervix.
Pathophysiology
!make sure you patho is a"out your patient. #ont include factors not applica"le to your
patient.
Predisposing factors:
!ultiparity ?<0$ of affected clients@ patient is not multipara
1dvanced maternal age ?older than 2# years old@ age?
!ultiple gestation ?
Previous cesarean birth not applica"le
&terine incisions not applicable
Prior placenta previa ?
&omplications for the baby
Problems for the baby, secondary to acute blood loss
Intra uterine groth retardation due to placental perfusion
'aboratory and diagnostic e(am
)edical )anagement
*urgical management
+rug *tudy
Nursing intervention
Procedure +escription,+efinition -ndication
1. IF+ %herapy
)#9*3 19 x 20 gttsGmin
used to supply ater and
electrolytes ?e.g., calcium,
potassium, sodium, chloride@,
2. 72 %herapy
2 9iterGmin via nasal
cannula
2. &ltrasound
?-ov. 2, 2011@
Placenta Previa partialis
+etal gender" 4aby boy
If continuation of the pregnancy is deemed safe for the patient and fetus
administer magnesium sulafate as ordered for premature labor.
7btain blood samples for complete blood count and blood type and cross
matching
Institute complete bed rest
8ave oxygen readily available for use should fetal distress occur
1dminister prescribed IF fluids and blood products
H. If the fetus less than 2H ee=s gestation expect to administer an initial dose of
betamethasone
6. (xplain that the fetus survival depends on gestational age and the amount of
maternal blood loss.
(ncourage the patient and her family to verbali'e their feelings help them to
develop effective coping strategies, and refer them in counselling, if necessary.
Nursing care plan