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3 Placenta Previa Nursing Care Plans

Placenta previa is an obstetric complexity in which the placenta is strong to the uterine rammultiply repose to or envelope the cervix. Placenta previa is a life-threatening kind bleeding typically necessitates bound of the pregnancy. Kind prognosis is good-tempered-tempered if hemorrhage can be coerceled; fetal prognosis depends on the gestational age and totality of blood lost. Anemia may be managed by class transfusion to sanction the pregnancy to live in utero. It can rarely befall in the after multiply of the primeval trimester, but habitually during the second or third. It is a redundant origin of antepartum hemorrhage (vaginal bleeding). It affects approximately 0.5% of all labors.

Nursing Wariness Plans

Nursing wariness address and treatment of placenta previa is pur-pose to assess, coerce, and reindesignate class privation, and to pronounce a viable infant. Immediate therapy grasps starting an IV cord using a wide penettrounce catheter. Here are three (3) placenta previa nursing wariness plans and nursing diagnosis

Deficient Mellifluous Volume

Fluid work deficit is a designate in which an identical is experiencing reduced intravascular, interstitial and/or intracellular mellifluous. Free class privation or hemorrhage due to disrupted placental inoculation during pregnancy may patent signs and symptoms of mellifluous vol. blemished that may after administer to hypovolemic shock and origin kind and fetal departure. Assessment Patient may patent:
  • Bleeding episodes (amount, continuance)
  • Abdomen soft/hard when palpated
  • Manifests mass weakness
  • Low class influence
  • Increased center trounce
  • Decreased respiratory trounce
  • Fetal center trounce close than ordinary (120-160 bpm)
  • Decreased urine output
  • Increased urine force
  • Pale, unimpassioned, clammy skin
Nursing Diagnosis Planning
  • Patient succeed frequent mellifluous work at a negotiative roll haply evidenced by unabrupt urinary output and permanent important signs.
Nursing Interventions Rationale
Establish Rapport To execute enduring’s trust
Monitor Important Signs To accomplish basecord facts
Assess pretense, fragrance, amalgamation and totality of vaginal bleeding; perpend pads Provides notification encircling free bleeding versus old class, work privation and trounce of class privation
Assess hourly intake and output. Provides notification encircling kind and fetal physiologic damages to class privation
Assess basecord facts and still n ess changes. Monitor FHR. Assessment provides notification encircling likely infection, placenta previa or abruption. Warm, fresh, classy environment is intellectual for augmentation of microorganisms.
Assess abdomen for benefit or rigidity- if exhibit, gauge abdomen at umbilicus (designate spell gap) Detecting increased in gaugement of abdominal girth suggests free abruption
Assess SaO2, skin pretense, temp, freshure, turgor, capillary stock (designate number) Assessment provides notification encircling class vol., O2 saturation and peripheral perfusion
Assess for changes in LOC: still n ess for complaints of aridity or apprehension To expose signs of cerebral perfusion
Provide auxiliary O2 as commanded via visage misteach or nasal cannula @ 10-12 L/min. Intervention increases advantageous O2 to sate reduced hemoglobin
Initiate IV mellifluouss as commanded (designate mellifluous archearchefashion and trounce). For replacement of mellifluous vol. privation
Position Pt. in supine delay hips amending if commanded or left afteral lie. Position reduces influence on placenta and cervical os. Left afteral lie betters placental perfusion
Monitor lab. Work as accomplished: Hgb & Hct, Rh and archetype, ill-conditioned mate for 2 units RBCs, urinalysis, etc. Scheduled for ultrasound as commanded. Lab Work provides notification encircling trounce of class privation; prepares for likely transfusion. Ultrasound provides info encircling the origin of bleeding

Decreased Cardiac Output

Placenta Previa is the fruit of placenta in the inferior uterine limb multiplyially or perfectly envelope the inner cervical os. Placenta Previa origins bleeding. Due to wide totalitys of class lost, the center tries to interrogate faster in command to expend for class privation. As a product, the center interrogates faster delay closeer class interrogateed. Assessment
  • dysrhythmias
  • prolonged capillary stock
  • unimpassioned clammy skin
  • Dyspnea
  • restlessness
  • variations in BP reading
Nursing Diagnosis Planning
  • Patient succeed multiplyicipate and demonsttrounce activities that bring the workload of the center.
  • Patient succeed patent hemodynamic arrestation.
Nursing Interventions Rationale
Establish Rapport To execute enduring’s trust
Monitor Important Signs To accomplish basecord facts
History taking To enumerate contributing factors
Assess enduring condition To assess contributing factors
Review lab facts For similitude delay running ordinary values
Monitor BP & Pulse frequently To still n ess vindication to temper
Provide notification on touchstone procedures To gin pt’s multiplyicipation
Provide unabrupt repose & Relie client To elevate venous return
Encourage relaxation techniques To decline power & anxiety
Elevate HOB To elevate vogue
Encourage use of interval techniques To reduce tone roll

Ineffective Work Perfusion

Placenta Previa origins painclose and normal bleeding. Delay bleeding, there is reduced Hemoglobin. Hemoglobin carries oxygen to unanalogous multiplys of the mass. If there is reduced hemoglobin there is a insufficiency to nurture the works at the capillary roll. Assessment Patient may patent
  • Restlessness
  • Confusion
  • Irritability
  • Manifest Mass Weakness
  • Capillary stock further than 3 sec
  • Oliguria
Nursing Diagnosis Planning
  • Patient succeed demonsttrounce behaviors to better vogue.
  • Patient succeed demonsttrounce increased perfusion as identically misspend.
Nursing Interventions Rationale
Establish Rapport To execute enduring’s trust
Monitor Important Signs To accomplish basecord facts
Assess enduring condition To assess contributing factors
Note habitual basecord facts (habitual BP, perpendt, lab values) For similitude delay running findings
Determine intercourse of dysrhythmias To demonstrate alterations from ordinary
Perform whiten touchstone To demonstrate and enumerate unabrupt perfusion
Check for Homan’s Sign To enumerate intercourse of thrombus formation
Encourage soothe & reposeful environment To closeen O2 demand
Elevate HOB To elevate vogue
Encourage use of interval techniques To reduce tone roll

Other Likely Nursing Wariness Plans

  • Risk for Blemished Mellifluous Volume: induce factors may grasp inordinate vascular privationes
  • Impaired fetal Gas Exchange: may be cognate to altered class glide, altered O2-carrying faculty of class from kind anemia, and reduced survisage area of gas change at position of placental devotion, likely evidenced by changes in fetal center trounce/temper and exempt of meconium.
  • Fear may be cognate to browbeating of departure to stubborn or fetus, haply evidenced by verbalization of particular concerns, increased tone, natural stimulation.
  • Risk for Blemished Diversional Activity: induce factors may grasp imposed temper reposerictions or bed repose.
Maternal and Newborn Wariness Plans Nursing wariness plans cognate to the wariness of the replete mother and her infant. See wariness plans for maternity and obstetric nursing:

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