Perfusion: Placenta Problems Flashcards
What is abruptio placenta?
Premature separation of a normally implanted placenta from the uterine wall
What can happen because of abruptio placenta?
Hemorrhage
What are the nursing interventions for abuptio placenta?
- Monitor uterine resting tone, which is frequently increased with abruption placentae
- Monitor abdominal girth measurements to determine blood collection
- Monitor VS, hgb and hematocrit, and urine output
What are some possible causing factors of abruptio placenta?
- maternal HTN
- multiple pregnancies
- smoking
- use of alcohol
- use of cocaine
What are the three types of abruptio placenta?
- central
- marginal
- complete
What is the most common symptom of abruptio placenta?
painful vaginal bleeding, rigid abdomen
What collaborative tests and interventions might be conducted for Abruptio placentae?
- IV fluids (LR)
- Lab work (H&H)
- PT and PTT
- Type and cross match for 3-4 units of blood or packed cells
- Induction of labor if separation is small (moderate to severe= C-section ASAP)
- RhoGAM to Rh-negative mom’s
- Plasma
What are the nursing interventions for abruptio placentae?
- Monitor FHR, maternal VS, Maternal I/O, mom’s LOC
- Assess Mom for S/S of shock
- Provide O2 to mom
- Have mom lie on side
- Allow time for privacy to grieve if applicable
- Contact clergy if requested by patient
- Encourage family to talk about their feelings
- Patient education about condition, pain relief, etc.
What is placenta previa?
Implantation of the placenta in the lower uterine segment rather than the upper portion, resulting in placental separation with dilation of the cervix
What are the nursing interventions for placenta previa?
- teach all pregnant women the importance of reporting any bright red vaginal bleeding, often scant at first
- Avoid vaginal examination of placenta previa is suspected
- Assess blood loss, pain, VS, fetal well-being, and uterine contractility
- Provide emotional support for the mother and family
What is the classic symptom of placenta previa?
Painless bleeding in the last half of pregnancy
What is the medical management needed for placenta previa?
- goal is to maintain the pregnancy
- Diagnosis is made with US
- H & H every 12 hours
- C-section
- May give betamethasone to the mother to help mature the fetus’ lungs
- Client is on bed rest with BRP as long as no bleeding occurs. Complete BR if bleeding
What is placenta accreta?
- the chorionic villi attach directly to the myometrium of the uterus in placenta accrete
- The adherence itself may be total, partial, or focal, depending on the amount of placental involvement
What is placenta increta?
Myometrium is invaded
What is placenta perceta?
Where the myometrium is penetrated
