Perfusion: Placenta Problems

Question 1

What is abruptio placenta?

Answer 1

Premature separation of a normally implanted placenta from the uterine wall

Question 2

What can happen because of abruptio placenta?

Answer 2

Hemorrhage

Question 3

What are the nursing interventions for abuptio placenta?

Answer 3

1. Monitor uterine resting tone, which is frequently increased with abruption placentae
2. Monitor abdominal girth measurements to determine blood collection
3. Monitor VS, hgb and hematocrit, and urine output

Question 4

What are some possible causing factors of abruptio placenta?

Answer 4

1. maternal HTN
2. multiple pregnancies
3. smoking
4. use of alcohol
5. use of cocaine

Question 5

What are the three types of abruptio placenta?

Answer 5

1. central
2. marginal
3. complete

Question 6

What is the most common symptom of abruptio placenta?

Answer 6

painful vaginal bleeding, rigid abdomen

Question 7

What collaborative tests and interventions might be conducted for Abruptio placentae?

Answer 7

1. IV fluids (LR)
2. Lab work (H&H)
3. PT and PTT
4. Type and cross match for 3-4 units of blood or packed cells
5. Induction of labor if separation is small (moderate to severe= C-section ASAP)
6. RhoGAM to Rh-negative mom’s
7. Plasma

Question 8

What are the nursing interventions for abruptio placentae?

Answer 8

1. Monitor FHR, maternal VS, Maternal I/O, mom’s LOC
2. Assess Mom for S/S of shock
3. Provide O2 to mom
4. Have mom lie on side
5. Allow time for privacy to grieve if applicable
6. Contact clergy if requested by patient
7. Encourage family to talk about their feelings
8. Patient education about condition, pain relief, etc.

Question 9

What is placenta previa?

Answer 9

Implantation of the placenta in the lower uterine segment rather than the upper portion, resulting in placental separation with dilation of the cervix

Question 10

What are the nursing interventions for placenta previa?

Answer 10

1. teach all pregnant women the importance of reporting any bright red vaginal bleeding, often scant at first
2. Avoid vaginal examination of placenta previa is suspected
3. Assess blood loss, pain, VS, fetal well-being, and uterine contractility
4. Provide emotional support for the mother and family

Question 11

What is the classic symptom of placenta previa?

Answer 11

Painless bleeding in the last half of pregnancy

Question 12

What is the medical management needed for placenta previa?

Answer 12

1. goal is to maintain the pregnancy
2. Diagnosis is made with US
3. H & H every 12 hours
4. C-section
5. May give betamethasone to the mother to help mature the fetus’ lungs
6. Client is on bed rest with BRP as long as no bleeding occurs. Complete BR if bleeding

Question 13

What is placenta accreta?

Answer 13

1. the chorionic villi attach directly to the myometrium of the uterus in placenta accrete
2. The adherence itself may be total, partial, or focal, depending on the amount of placental involvement

Question 14

What is placenta increta?

Answer 14

Myometrium is invaded

Question 15

What is placenta perceta?

Answer 15

Where the myometrium is penetrated

Question 16

What are the nursing interventions for placenta accreta?

Answer 16

1. assess for bleeding
2. Monitor VS
3. Prepare women for surgical intervention and possible hysterectomy