Only $35.99/year

Terms in this set (25)

Placenta Abruption
● RISK FACTORS
○ Maternal hypertension, cocaine, abdominal trauma, polyhydramnios, multiple gestation, previous placental abruption
● SIGNS AND SYMPTOMS:
○ May have sudden onset of intense usually localized abdominal (uterine) pain with or without vaginal bleeding
○ Vary with degree of separation
○ Abdominal pain, rigid abdomen
○ Vaginal bleeding
○ Bloody stained amniotic fluid
○ Uterine contractions or hypertonus
○ Abnormal FHR patterns
● NURSING INTERVENTIONS
○ Watch for s/s of DIC
○ Assess bleeding/vital signs including fundal height and abdominal girth
○ No abdominal manipulation or vaginal exams until placenta previa ruled out
○ NO SUPINE ← left side lying position
○ Monitor FHR continuously with external monitors
○ Type and cross, CBC, clotting factors, Rh factor
○ IV start & fluids
○ Prep for delivery → possibly cesarean
○ REPORT: tachysystole, FHR changes
○ Observe for signs of shock
Placenta Previa
● RISK FACTORS
○ Previous placenta previa, previous C section, smoking, maternal age over 35, multiple gestations, etc.
● SIGNS AND SYMPTOMS
○ Usually painless uterine bleeding 2nd or 3rd trimester
○ Uterine tone soft upon palpation
● NURSING INTERVENTIONS depends on...
○ Amount of bleeding
○ Labor status
○ Gestational age
○ Fetal response
○ If labor active and os is completely covered, C/S indicated
○ If bleeding controlled and labor absent, conservative management:
■ Activity limitation
■ No tampon use
■ No sexual intercoarse
■ Monitor and report bleeding
■ Patient instructed to report diagnosis when admitted to hospital
■ Cesarean preparation class
○ Count fetal movements