Placenta Previa

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Statement of Objectives
General
To render efficient and effective nursing care by the utilization of the nursing process Specific
1. To establish rapport with the patient.
2. To acquire knowledge and fully understand the disease process. 3. To gather vital information or data about the patient.

PATIENT’S PROFILE
Name: Anabelle Tud
Birthday: November 10, 1968
Address: District 1 Gigmoto, Catanduanes
Religion: Roman Catholic
Age: 43 years old
Civil Status: Married
Date of Admission: August 13, 2012, 9:30pm

Complaint: RLQ pain
Tentative Diagnosis: PU 32-33 wks, AOG CML, T/C UTI G11P10
Final diagnosis: PU 32- 33 wks AOG, Placenta Previa partialis Attending Physician: Dr. Romano

Physical examination upon admission:
conscious and coherent
V/S taken as follows:
Blood pressure: 110/70 mmhg
Pulse rate: 98 bpm
Resp. rate: 20 bpm
Temperature: 36.9 *C
Obstetric History
Age of menarche: 15 yrs of age
Interval: monthly
Duration: 3 days flow
Flow: moderate
AOG: 32. 33 FHT: 134 bpm FH: 24 cm

Health History
Anabelle tud is a 43 year old woman, married, living in District 1, Gigmoto, Catanduanes.she had her menarche at the age of 15. She has 10 children and currently having her 11th baby. Her last child was born 2 years ago. All of her child was born NSD and she has not been hypertensive since.

Curretly, anabelle was on her 8th month of pregnancy. While seating on a bench, she suddenly felt a very severe pain in the right lower quadrant of her abdomen. She didnt ot felt this kid of pain ever in her entire pregnancy. She describes the pain as if she is on labor. She was then admitted to the OB ward-EBMC.

Her urine was tested and she was internally examined by DR. Rendon and found out that he cervix was not dilated. Her urine was positive for UTI. Initial Physical Examination
Upon initial physical examination, Mrs. Anabelle was diaphoretic, with bounding peripheral pulses, hypertensive with a BP of 150/100mmHg, with deep shallow respiration with a rate of 34 breaths per minute. Her contractions was irregular, she is in severe pain with a scale of 10/10, radiating from the right lower quadrant to superior anterior of her abdomen. She has not voided since admission. She cant move and her own and requires assistance most of the time.

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 factorsare 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:
Total Previa- the placenta completely covers the internal cervical os. Partial Previa- the placenta covers a part of the internal cervical os. Marginal Previa- the edge of the placenta lies at the margin of the internal cervical os and may be exposed during dilatation. Low-lying placenta- the placenta is implanted in the lower uterine segment but does not reach to...
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