Question

Shannon is 28 weeks’ pregnant and is admitted to the hospital with what the patient describes as painless bleeding. She is placed on the external fetal monitor; the baby has a baseline of 130 bpm with moderate variability.

1.What do you suspect is happening?

2.Describe the clinical manifestations of this condition and discuss expected management of care for this patient.

3.Select one nursing diagnosis and R/T statement for the patient.

Answer 1

1.Placenta previa is the condition which is seen in this case. Placenta previa is defined as a condition in which the placenta as a whole or partially is inserted into the lower part of the uterus or the cervix.This is most common in third trimenster of pregnancy and can cause painless bleeding and can be diagnosed with the help of an ultrasound.

2.Clinical manifestation

-Bright red, painless bleeding which is the classical sign of placenta previa

-Some womens may have contrations

-Some may have severe bleeding during of before or after delivery.

-Mostly seen in 3rd trimester of pregnancy

Management

Management depends according to the type of placenta previa, sevearity of bleeding and mothers and fetal health.

Nothing can be done to change the position of the placenta so the only management of placenta previa is bed rest and limitation of activity.

In certain condition where the bleeding is heavy the early delivery or Caesarean section is conducted and this is mostly prefered in complete placenta previa.

Ultrasound can be used to locate the uterus and monitoring fetal heart rate and antenata examination help to identify the health status of mother and fetus.

Advice the patient to take complete bed rest and limitations m of activities , and also explain regarding the condition and provide her psychological support.

3.Nursing diagnosis

-Fluid volume deficit related to active bleeding as manifested by patient lab reports.

-Fear and anxiety related to active bleeding as manifested by facial expressions.

-Knowledge deficit related to disease condition as manifested by frequently asking questions .