Placenta Previa Nursing Care Plans Diagnosis and InterventionsPlacenta Previa NCLEX Review and Nursing Care Plans Show
The placenta is the structure that develops inside the uterus and envelops the unborn fetus. This supplements the fetus of the needed nutrients and oxygen. Also, it serves as a medium for the elimination of by-products and wastes from the fetus. In most pregnancies, the placenta attaches at the top or side of the placenta. In placenta previa, the placenta attaches into the bottom part and near the cervix, which is the outlet of the uterus. The condition may be partial or complete obstruction of the cervix, hence the name of its two types, complete placenta previa and partial placenta previa. Tearing of this membrane during pregnancy and delivery predisposes the patient to severe bleeding, which is life-threatening to both the mother and fetus. A combination of preventive measures, corrective surgery and pharmacological management are utilized to manage placenta previa. Signs and Symptoms of Placenta PreviaPlacenta previa occurs usually at the second or third trimester of pregnancy. It presents as a sudden, painless, bright red vaginal bleeding which may or may not have associated uterine contractions. It often stops spontaneously then recurs during active labor. Majority of patients diagnosed with placenta previa resolves naturally as the fetus grows and the distance between the cervix and placenta increases. However, there are some instances wherein this is not the case, thus making it riskier for the mother and her unborn child. The risk compounds even further if the placenta lies nearer to the cervical opening. Upon physical examination, a mother with placenta previa may have:
Causes and Risk factors of Placenta PreviaThe exact cause of the condition is unknown. Susceptibility in developing placenta previa generally may either be by internal factors (race and ethnicity), external (e.g. smoking), latent and/or causative risks (gynecologic history). Nevertheless, there are risk factors associated to its development and they are:
Complications of Placenta PreviaMaternal complications associated with placenta previa are:
Neonatal/fetal complications associated with placenta previa are:
Treatment for Placenta Previa
For little to no bleeding – It is recommended to avoid strenuous activities that may trigger bleeding. For heavy bleeding – Treatment would entail immediate medical management and blood transfusions to manage effectively. Caesarian sections would be the preferred choice for delivering the baby to avoid complications. If planned delivery will be earlier than 37 weeks age of gestation, corticosteroids is prescribed to help the fetus’ lungs to develop. For uncontrolled bleeding – Immediate C-section will be performed, regardless if the fetus is premature or in full term. Corrective surgery to control the bleeding will also be done and may involve some surgical techniques such as:
Nursing Diagnosis for Placenta PreviaNursing Care Plan for Placenta Previa 1Nursing Diagnosis: Altered Uteroplacental Tissue Perfusion related to maternal bleeding secondary to placenta previa, as evidenced by intrauterine fetal growth retardation viewed in the scans and changes in fetal heart rate Desired Outcome: Patient has stable fetal heat rate when subjected to contraction stress test.
Nursing Care Plan for Placenta Previa 2Nursing Diagnosis: Deficient Fluid Volume related to active blood loss secondary to placenta previa, as evidenced by an average blood pressure level of 85/50, body weakness, decreased urinary output, decreased fetal heart rate, and pale, clammy skin Desired Outcome: The patient will re-establish a functional body fluid volume and a balanced input and output status.
Nursing Care Plan for Placenta Previa 3Nursing Diagnosis: Decreased cardiac output related to altered cardiac contractility secondary to placenta previa, as evidenced by cardiac dysrhythmias, cold and clammy skin, shortness of breath, variations in blood pressure readings, and restlessness Desired Outcome: The patient will have an improved cardiac output through well-controlled blood pressure levels throughout the remainder of her pregnancy.
Nursing Care Plan for Placenta Previa 4Impaired Gas Exchange (Fetal) Nursing Diagnosis: Impaired gas exchange (fetal) related to altered blood flow, altered oxygen-carrying capacity of blood from maternal anemia, and decreased surface area of gas exchange at site of placental attachment, possibly evidenced by changes in fetal heart rate/activity and release of meconium Desired Outcome:The patient (fetus) will be able to maintain normal heart rate, with the absence of meconium staining and fetal distress.
Nursing Care Plan for Placenta Previa 5Fear Nursing Diagnosis: Fear related to threat of death to self or fetus, possibly evidenced by verbalization of specific concerns, increased tension, sympathetic stimulation. Desired Outcomes:
Nursing Care Plan for Placenta Previa 6Deficient Knowledge Nursing Diagnosis: Deficient Knowledge related to lack of exposure to proper and accurate information secondary to placenta previa as evidenced by knowledge-seeking behaviors and the lack of comprehension regarding the condition and its management. Desired Outcome: The patient will be able to gain sufficient and accurate knowledge that is needed for addressing the healthcare goals of the patient.
More Placenta Previa Nursing Diagnosis
Nursing ReferencesAckley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon Disclaimer:Please follow your facilities guidelines, policies, and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. What are the nursing interventions for placenta previa?Placenta Previa Nursing Interventions
Instruct the patient to have bedrest and avoid environmental stressors. To avoid further bleeding, maintain blood pressure levels, improve cardiac rate, and enhance utero-placental perfusion. For high blood pressure levels, administer antihypertensives as prescribed.
What intervention should be completed for a client with placenta previa?Answer: A.
Treatment of partial placenta previa includes bed rest, hydration, and careful monitoring of the client's bleeding.
What is the best management for placenta previa?Treatment of placenta previa involves bed rest and limitation of activity. Tocolytic medications, intravenous fluids, and blood transfusions may be required depending upon the severity of the condition. Cesarean delivery is required for complete placenta previa.
What would be your priority nursing intervention when dealing with a PX diagnosed with placenta previa?Nursing care management and treatment of placenta previa is design to assess, control, and restore blood loss, and to deliver a viable infant. Immediate therapy includes starting an IV line using a large bore catheter.
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