What are the nursing diagnosis for placenta previa?
Introduction: Show The placenta is implanted in the lower uterine segment near or over the internal cervical os. The degree to which the internal cervical os is covered by the placenta has been used to classify four types of placenta previa; total, partial, marginal and low–lying. In total previa the internal os is entirely covered by the placenta. Partial placenta previa implies incomplete coverage of the internal os. Marginal placenta previa indicates that only an edge of the placenta extends to the margin of the internal os. And the last is the low – lying placenta has been used when the placenta is implanted in the lower uterine segment but not reach the os. The more descriptive classification that includes placenta previa is in the third trimester. The incidence of placenta previa is approximately 0.5% of births. The most important risk factors are previous placenta previa, previous cesarean birth, and suction curettage for miscarriage or induced abortion, possible related to endometrial scarring. The risk also increases with multiple gestations because of the larger placental area, closely spaced pregnancies, advanced maternal age older than 34 years, African or Asian ethnicity, male fetal sex, smoking, cocaine use, multiparity, and tobacco use. Classification of Placenta Previa:
Predisposing Factors:
Complications for the baby include:
Clinical Manifestations:
Normal Placenta During Childbirth Process of placental growth and uterine wall changes during pregnancy
Anatomy of the uterine/placental compartment at the time of birth
Anatomy of Female Reproductive System Pathophysiology No specific cause of placenta previa has yet been found but it is hypothesized to be related to abnormal vascularisation of the endometrium caused by scarring or atrophy from previous trauma, surgery, or infection. In the last trimester of pregnancy the isthmus of the uterus unfolds and forms the lower segment. In a normal pregnancy the placenta does not overlie it, so there is no bleeding. If the placenta does overlie the lower segment, it may shear off and a small section may bleed. Women with placenta previa often present with painless, bright red vaginal bleeding. This bleeding often starts mildly and may increase as the area of placental separation increases. Praevia should be suspected if there is bleeding after 24 weeks of gestation. Abdominal examination usually finds the uterus non-tender and relaxed. Leopold’s Maneuvers may find the fetus in an oblique or breech position or lying transverse as a result of the abnormal position of the placenta. Praevia can be confirmed with an ultrasound.[3] In parts of the world where ultrasound is unavailable, it is not uncommon to confirm the diagnosis with an examination in the surgical theatre. The proper timing of an examination in theatre is important. If the woman is not bleeding severely she can be managed non-operatively until the 36th week. By this time the baby’s chance of survival is as good as at full term. Diagnostic Evaluation: Placenta previa is diagnosed using transabdominal ultrasound. Transvaginal ultrasound
Ultrasonographic scan
Complete blood count (CBC)
Fetoscope
Medical Management:
Nursing Interventions:
Discharge Plan: Medication
Exercise
Treatment
Health Teaching
Ongoing Assessment
Diet
Spiritual
Possible Nursing Diagnosis for Placenta Previa:
View Nursing Care Plan – Placenta Previa References:
Daisy Jane Antipuesto RN MN Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer. What Do You Think?What are 5 nursing diagnosis?The following are nursing diagnoses arising from the nursing literature with varying degrees of authentication by ICNP or NANDA-I standards.. Anxiety.. Constipation.. Activity Intolerance.. Impaired Gas Exchange.. Excessive Fluid Volume.. Caregiver Role Strain.. Ineffective Coping.. What are the differential diagnosis of placenta previa?If undiagnosed preoperatively, placenta previa may be diagnosed or confirmed at cesarean section. The differential diagnoses of placenta previa include abruptio placentae, local cervical lesions (polyps, carcinoma), circumvallate placenta, vasa previa or heavy show.
What are the 4 nursing diagnosis?There are 4 types of nursing diagnoses: risk-focused, problem-focused, health promotion-focused, or syndrome-focused.
What are examples of potential nursing diagnosis?Examples of nursing diagnosis: risk for impaired liver function; urinary retention; disturbed sleep pattern; decreased cardiac output. On the other hand, a medical diagnosis is made by a doctor or advanced health care practitioner.
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