Thủ Thuật Hướng dẫn When planning care for a patient admitted to the hospital with placenta previa the nurses primary goal is to? Chi Tiết
Bùi Lam Khê đang tìm kiếm từ khóa When planning care for a patient admitted to the hospital with placenta previa the nurses primary goal is to? được Cập Nhật vào lúc : 2022-09-02 04:56:02 . Với phương châm chia sẻ Mẹo về trong nội dung bài viết một cách Chi Tiết 2022. Nếu sau khi Read Post vẫn ko hiểu thì hoàn toàn có thể lại Comment ở cuối bài để Tác giả lý giải và hướng dẫn lại nha.Vaginal bleeding - placenta previa; Pregnancy - placenta previa
Nội dung chính- Exams and TestsOutlook (Prognosis)When to Contact a Medical Professional
References Version InfoWhat is the nursing priority for placenta previa?What nursing interventions should be included when caring for a patient with placenta previa?How will you manage a patient with placenta previa?When Managing placenta previa What is the plan of care if the patient is home?
Placenta previa is a problem of pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix.
The placenta grows during pregnancy and feeds the developing baby. The cervix is the opening to the birth canal.
1. The uterus is exposed through the abdominal wall, and an incision is made in the uterine covering. 2. The muscles of the uterus are separated, producing a hole for the delivery of the infant. 3. The infant is delivered through the opening in the uterine wall, after which, the uterus is stitched closed.
The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing numbers of conditions including meningomyelocele, congenital heart disease, kidney abnormalities, hydrocephalus, anencephaly, club feet, and other deformities. Ultrasound does not produce ionizing radiation and is considered a very safe procedure for both the mother and the fetus.
The placenta provides the fetus with oxygen and nutrients and takes away waste such as carbon dioxide via the umbilical cord.
Placenta previa is a condition of pregnancy when the placenta implants in the lower part of the uterus, partly or completely obstructing the cervical outlet to the vagina (birth canal).
In the placenta, nutrients, wastes, and gases are exchanged between the mothers blood and the babys blood.
This is a normal fetal ultrasound performed 19 weeks gestation. This is the type of spilt-screen display you might see during an ultrasound, or if the technician prints a copy of the ultrasound for you. This ultrasound shows both the left arm (seen in the left side of the display), and the lower extremities (seen in the right side of the display). The white areas of the arm or legs is developing bone.
This is a normal fetal ultrasound performed 19 weeks gestation. This ultrasound shows two interesting features. In the foreground, to the left and middle of the screen, you can see the placenta, following the curve of the uterus. In the background on the right, where the cross hair is pointing, you can see the face with all the facial features visible.
This is a normal color Doppler ultrasound of the umbilical cord performed 30 weeks gestation. The cord is the colored area in the middle of the screen, with the different blood vessels represented by different colors. There are normally three vessels in the cord, two arteries and one vein. The umbilical cord is connected to the placenta, located in the middle left of the image.
The placenta supplies the fetus with the blood supply and nutrients necessary for survival.
Causes
During pregnancy, the placenta moves as the womb stretches and grows. It is very common for the placenta to be low in the womb in early pregnancy. But as the pregnancy continues, the placenta moves to the top of the womb. By the third trimester, the placenta should be near the top of the womb, so the cervix is open for delivery.
Sometimes, the placenta partly or completely covers the cervix. This is called a previa.
There are different forms of placenta previa:
- Marginal: The placenta is next to the cervix but does not cover the opening.Partial: The placenta covers part of the cervical opening.
Complete: The placenta covers all of the cervical opening.
Placenta previa occurs in 1 out of 200 pregnancies. It is more common in women who have:
- An abnormally shaped uterusHad many pregnancies in the pastHad multiple pregnancies, such as twins or tripletsScarring on the lining of the uterus due to a history of surgery, C-section, or abortionIn vitro fertilization
Women who smoke, use cocaine, or have their children an older age may also have an increased risk.
Symptoms
The main symptom of placenta previa is sudden bleeding from the vagina. Some women also have cramps. The bleeding often starts near the end of the second trimester or beginning of the third trimester.
Bleeding may be severe and life threatening. It may stop on its own but can start again days or weeks later.
Labor sometimes starts within several days of the heavy bleeding. Sometimes, bleeding may not occur until after labor starts.
Exams and Tests
Your health care provider can diagnose this condition with a pregnancy ultrasound.
Treatment
Your provider will carefully consider the risk of bleeding against early delivery of your baby. After 36 weeks, delivery of the baby may be the best treatment.
Nearly all women with placenta previa need a C-section. If the placenta covers all or part of the cervix, a vaginal delivery can cause severe bleeding. This can be deadly to both the mother and baby.
If the placenta is near or covering part of the cervix, your provider may recommend:
- Reducing your activitiesBed restPelvic rest, which means no sex, no tampons, and no douching
Nothing should be placed in the vagina.
You may need to stay in the hospital so your health care team can closely monitor you and your baby.
Other treatments you may receive:
- Blood transfusionsMedicines to prevent early laborMedicines to help pregnancy continue to least 36 weeksShot of special
medicine called Rhogam if your blood type is Rh-negativeSteroid shots to help the baby's lungs mature
An emergency C-section may be done if the bleeding is heavy and cannot be controlled.
When it's not possible or safe for a woman to deliver a baby naturally through her vagina, she will need to have her baby delivered surgically, a procedure referred to as cesarean section, or C-section. I know this is a controversial topic recently, sometimes people talk C-sections being done too often. That may be true, but when it is necessary, it can be life saving for mother or baby. A C-section is the delivery of a baby through a surgical opening in the mother's lower belly area, usually around the đồ lót line. The procedure is most often done while the woman is awake. The body toàn thân is numbed from the chest to the feet using epidural, or spinal, anesthesia. The surgeon usually makes a cut or incision across the belly just above the pubic area. The surgeon opens the womb, or uterus, and the amniotic sac, then delivers the baby. A woman may have a C-section if there are problems with the baby, such as an abnormal heart rate, abnormal positions of the baby in the womb, developmental problems in the baby, a multiple pregnancy like triplets, or when there are problems with the placenta or umbilical cord. A C-section may be necessary if the mother has medical problems, such as an active genital herpes infection, large uterine fibroids near the cervix, or if she is too weak to deliver due to severe illness. Sometimes a delivery that takes too long, caused by problems like getting the baby's head through the birth canal, or in the instance of a very large baby may make a C-section necessary. Having a C-section is a safe procedure. The rate of complications is very low. However, there are some risks, including infection of the bladder or uterus, injury to the urinary tract, and injury to the baby. A C-section may also cause problems in future pregnancies. The average hospital stay after a C-section is 2 to 4 days, and keep in mind recovery often takes longer than it would from a vaginal birth. Walking after the C-section is important to speed recovery and pain medication may be supplied too as recovery takes place. Most mothers and infants do well after a C-section, and often, a woman who has a C-section may have a vaginal delivery if she gets pregnant again.
Outlook (Prognosis)
The biggest risk is severe bleeding that can be life threatening to the mother and baby. If you have severe bleeding, your baby may need to be delivered early, before major organs, such as the lungs, have developed.
When to Contact a Medical Professional
Call your provider if you have vaginal bleeding during pregnancy. Placenta previa can be dangerous to both you and your baby.
References
Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 18.
Hull AD, Resnik R, Silver RM. Placenta previa and accreta, vasa previa, subchorionic hemorrhage, and abruptio placentae. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 46.
Salhi BA, Nagrani S. Acute complications of pregnancy. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2022:chap 178.
Version Info
Last reviewed on: 6/8/2022
Reviewed by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
What is the nursing priority for placenta previa?
Administering oxygen may be helpful, but the priority is to change the woman's position and relieve cord compression. Treatment of partial placenta previa includes bed rest, hydration, and careful monitoring of the client's bleeding.What nursing interventions should be included when caring for a patient with placenta previa?
Planning.How will you manage a patient with placenta previa?
Treatment / Management. With the diagnosis of placenta previa, the patient is scheduled for elective delivery 36 to 37 weeks via cesarean section. ... . Patients with excessive or continuous vaginal bleeding should be delivered via cesarean section regardless of gestational age..When Managing placenta previa What is the plan of care if the patient is home?
trang chủ care is not always appropriate, and women who remain home must be able to access medical care immediately should bleeding resume. Women with placenta previa in the 3rd trimester of pregnancy are advised to avoid sexual intercourse and exercise and to reduce their activity level. Tải thêm tài liệu liên quan đến nội dung bài viết When planning care for a patient admitted to the hospital with placenta previa the nurses primary goal is to?