Question

placenta previa (please fill in every box)

ACTIVE LEARNING TEMPLATE: System Disorder STUDENT NAME DISORDER/DISEASE PROCESS Placenta Previa REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care ACTIVE LEARNING TEMPLATES

Answer 1

Diagnosis 1.Fresh red   bleeding P/v (profuse ) 2.No pain 3.usually after first trimester,in second trimester (after 20 weeks of gestation

Pathophysiology Low lying placenta covering internal os of uterus instead of upper uterus.            Either fully obstructing            Partially obstructing or            Marginally obstructing the internal os

Health promotion and disease Prevention Good antenatal care of the mother Special antenatal care in mother over 35 yrs of age, multipara, with previous Cesarian section case H/o Mother smoking etc

RISK FACTORS	Findings
Mother age>35 yrs Smoking Multipara Previous caesarean section or operation in uterus More than normal size of placenta I,e larger placenta(Twins etc) More than one no of placenta	Placenta occludes either partially or fully the internal os.in USG

Lab Tests	Diagnostic procedure
Prenatal Ultrasound	1.Placental ultrasound 2.Sometimes during labour if not proper antenatal care done

Safety consideration 1.If mother is having profuse bleeding give blood and blood products intravenously 2. Emergency C.S in fetal hypoxia

Nursing care	Medication Blood supplements like Packed cell transfusion in severe bleeding	Client education
Observations of any bright red painless bleeding Support to the patient Support for absolute Bed rest		To contact healthcare personnel immediately in any case of painless red bleeding ,sometimes if preterm contraction should be reported. Good antenatal check up in the mother having already told risk factors
Therapeutic procedure		Inter professional care
If foetal hypoxia Caesarean Section		Good delegation of communication to mother for proper pelvic rest and if spotting or bleeding starts then consultation of doctor and foetal monitoring . Good delegation of supervision Both mother and foetus

Complications

1.Mother      Haemorrahage related maternal complications like shock

2.Foetus       Preterm delivery and foetal hypoxia,if severe foetal death