Bleeding Complications Flashcards
Abnormal implantation of the placenta blocking cervix =
placenta previa
Premature separation of the placenta from the uterus=
Abruptio Placentae (Abruption)
low lying vs complete placenta previa
low lying= near cervix
Complete= placenta covers all of cevix, can be emergent!
when do you see bleeding from placenta previa?
3rd trimester
risk factors for placenta previa
• can happen to anyone for no reason!
interventions for placenta previa
• Pelvic rest – No vaginal exams, nothing inserted vaginally, no intercourse
◦ do not want to cause disruption to cervical blood vessels or cause premature separating of the placenta from uterus
• Monitor fetus for distress –> mom can lose 40% of blood before seeing s/s of shock
• C-section
anytime a client has bleeding after 24 weeks we suspect….
placenta previa
s/s of placenta previa
- Painless Bright Red Bleeding
- Relaxed soft uterus, non-tender
- Episodes of bleeding (mild-profuse) (End of 2nd and 3rd Trimester)
- Visible bleeding
- Intercourse post bleeding
- Abnormal fetal position
When does placental abruption usually occur?
3rd trimester
Types of placental abruption?
- Partial or Complete
* Concealed or Apparent
Risk factors for placental abruption?
- **Hypertension
- Substance abuse – cocaine use
- Smoking
- Trauma
- Multifetal pregnancy
s/s of placental abruption?
◦ D – dark red bleeding ◦ E – extended fundal height due to bleeding ◦ T – tender uterus ◦ A – abdominal pain / contractions ◦ C – concealed bleeding ◦ H – hard abdomen ◦ E – experience DIC ◦ D – distressed baby, decels
Lab/diagnostics for placental abruption
H&H, type and cross for transfusion, ultrasound
Nursing interventions for placental abruption
ontinuous monitoring of fetus, large bore IV to administer blood/fluids, 8-10 L to fetus, mom v/s , urinary catheter for I&O
s/s of DIC
Watch for oozing from IV sites, petechiae, especially under the blood pressure cuff,
spontaneous bleeding from the gums and nose, signs of bruising, and hematuria
What is DIC? what can it lead to ?
= Disseminated intravascular coagulation
• happens when body breaks down clots faster than it can form them –> hemorrhage –> death
◦ Fertilized egg implants in tissue outside of the uterus=
ectopic preg
s/s of ectopic preg
- unliateral pain in lower quadrant
◦ Cullen’s sign - Ruptured ectopic pregnancy - blue discoloration around belly button
what is cullens sign?
- Ruptured ectopic pregnancy - blue discoloration around belly button
◦ overproduction of tissue that would normally develop into placenta –> no developing fetus =
• Hydatidiform mole
s/s of Hydatidiform mole
◦ severe N/V, hyperthyroidism, pre-eclampsia
a miscarriage occurs when you lose fetus before ____ weeks
20 weeks
types of miscarriages?
◦ complete/incomplete/missed
post miscarriage education?
vaginal rest after d&c of fetus
