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Placenta Previa for Certified Emergency Nursing (CEN)

Placenta Previa for Certified Emergency Nursing (CEN)

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Placenta Previa (Picmonic)

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Outline

Placenta Previa

Definition/Etiology:

Implantation of the placenta in the lower uterine segment or over the internal os.

Pathophysiology:

As the fetus grows, there is more pressure on the placenta. A placenta in this position has the potential to bleed through the cervix causing potential hemorrhage and risk to the fetus. Underlying etiology is unknown.

Risk factors include:

Advanced maternal age
multifetal gestation
smoking
previous c-section
hx of previous placenta previa

Clinical Presentation:

Sudden PAINLESS BRIGHT red bleeding in the second or third trimester
Uterus will be soft and non-tender (uterus is not the problem, placenta is)
May have increased fundal height due to the placenta pushing baby up
Signs of maternal shock may be present

Collaborative Management:

Large bore IVs for fluid resuscitation

Get labs:

CBC
BMP
Type and Cross
ABO

Evaluation | Patient Monitoring | Education:

Hemodynamic monitoring – watch for shock!
Fetal monitoring
VAGINAL EXAM = BIG NO NO
- Placenta is sitting on the top of the cervix so if you open the cervix, you could further disrupt the placenta
Usually results in a c-section

Linchpins: (Key Points)

Painless, bright red bleeding
Bedrest, no intercourse and no digital exams!
Gynecological emergency!!
Usually results in a c-section

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

Anderson-Bagga, F. M., & Sze, A. (2019). Placenta previa.
Sheehy, S. B., Hammond, B. B., & Zimmermann, P. G. (2013). Sheehy’s manual of emergency care. 7th ed. / St. Louis, Mo., Elsevier/Mosby.

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ob

Concepts Covered:

Labor Complications
Fetal Development
Terminology
Pregnancy Risks
Newborn Complications
Postpartum Care
Prenatal Concepts
Newborn Care
Postpartum Complications
Labor and Delivery
Studying
Communication
Medication Administration

Study Plan Lessons

Abruptio Placenta for Certified Emergency Nursing (CEN)

Adult Vital Signs (VS)

Alpha-fetoprotein (AFP) Lab Values

Antepartum Testing

Anti-Infective – Aminoglycosides

Anti-Infective – Lincosamide

Bicarbonate (HCO3) Lab Values

Blood Transfusions (Administration)

Body System Assessments

Cardiac (Heart) Disease in Pregnancy

Certified Nurse Midwife

Chorioamnionitis

Clindamycin (Cleocin) Nursing Considerations

Direct Bilirubin (Conjugated) Lab Values

Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)

Ectopic Pregnancy

Ectopic Pregnancy Case Study (30 min)

Emergent Delivery (OB) (30 min)

Emergent Delivery for Certified Emergency Nursing (CEN)

Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)

Erythroblastosis Fetalis

Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)

Family Planning & Contraception

Family Planning & Signs of Pregnancy – Live Tutoring Archive

Fetal Alcohol Syndrome (FAS)

Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)

Fundal Height Assessment for Nurses

Gestation & Nägele’s Rule: Estimating Due Dates

Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive

Glucagon Lab Values

Glucose Tolerance Test (GTT) Lab Values

Gravidity and Parity (G&Ps, GTPAL)

Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care

Hemoglobin A1c (HbA1C)

Hepatitis B Vaccine for Newborns

Homocysteine (HCY) Lab Values

Hydatidiform Mole (Molar pregnancy)

Hyperbilirubinemia (Jaundice)

Hypovolemic Shock Case Study (OB sim) (60 min)

Initial Care of the Newborn (APGAR)

Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)

Maternal Risk Factors

Newborn Physical Exam

Newborn Reflexes

Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage

Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Diabetes Mellitus (DM)

Nursing Care Plan (NCP) for Dystocia

Nursing Care Plan (NCP) for Ectopic Pregnancy

Nursing Care Plan (NCP) for Gestational Diabetes (GDM)

Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia

Nursing Care Plan (NCP) for Hyperemesis Gravidarum

Nursing Care Plan (NCP) for Hypertension (HTN)

Nursing Care Plan (NCP) for Incompetent Cervix

Nursing Care Plan (NCP) for Mastitis

Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Placenta Previa

Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)

Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)

Nursing Care Plan (NCP) for Preterm Labor / Premature Labor

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)

Nursing Care Plan for Newborn Reflexes

Nursing Case Study for Maternal Newborn

Nutrition Assessments

OB (Labor) Nurse Report to OB (Postpartum) Nurses

OB Course Introduction

OB Non-Stress Test Results Nursing Mnemonic (NNN)

OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive

Obstetric Trauma for Certified Emergency Nursing (CEN)

Obstetrical Procedures

Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)

Oxytocin (Pitocin) Nursing Considerations

Pediatric Vital Signs (VS)

Placenta Previa for Certified Emergency Nursing (CEN)

Postpartum Discomforts

Postpartum Hematoma

Postpartum Interventions

Precipitous Labor

Preterm Labor for Certified Emergency Nursing (CEN)

Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)

Process of Labor – Live Tutoring Archive

Process of Labor 2 – Live Tutoring Archive

Protein (PROT) Lab Values

Rh Immune Globulin (Rhogam)

Rh Immune Globulin in Pregnancy

Signs of Pregnancy – Live Tutoring Archive

Signs of Pregnancy (Presumptive, Probable, Positive)

Top 5 Misunderstood OB Concepts – Live Tutoring Archive