Page 118 - Critical Maternity & Newborn Health Nursing

Nursing Management for placenta previa:

 Placenta previa care

Remember the mnemonic: PREVIA

Painless bright red bleeding

Replace blood loss

Evident in lower segment

Vital indicate shock

Inspect FHR (Fetal Heart Rate).

Avoid vaginal exam

1. Ensure the physiologic well-being of the client and fetus.

 Take and record vital signs, assess bleeding, and maintain a

perineal pad count. Weigh perineal pads before and after use to

estimate blood loss.

 Observe for shock, which is characterized by a rapid pulse,

pallor, cold moist skin, and a drop in blood pressure.

 Monitor the FHR.

 Enforce strict bed rest to minimize risk to the fetus.

 Observe for additional bleeding episodes.

2. Provide client and family teaching

 Explain the condition and management options. To ensure an

adequate blood supply to the mother and fetus, place the

woman at bed rest in a side-lying position. Anticipate the order

for a sonogram to localize the placenta. If the condition of

mother or fetus deteriorates, a cesarean birth will be required.

 Prepare the client for ambulation and discharge (may be within

48 hours of last bleeding episode).

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