Summary NUR 350 Exam 4 Study Guide

Exam 4 SG OB



 Nursing management/intervention for mom expecting to
deliver a fetal demise.
o Evaluate what kind of personal support she has (spouse & family)
o Encourage her to hold her baby & give them privacy.
o Be mindful of religious beliefs.
o Bath baby, get footprints, weigh & measure the baby, take pictures.
 Placenta Previa
o 3 types:




o RISK FACTORS:
 Abnormal Uterus
 Multiple Pregnancies
 Scarring of uterus (previous surgeries, C-section, D&C & abortions)
 Smoking or drug use.
 Advance Maternal Age.
o S/S:
 Sudden bleeding in late 2nd or early 3rd trimester.
 Painless & bright red bleeding.
 FHR normal unless significant detachment of placenta occurs during
dilation & effacement.
 May be diagnosed by 2nd trimester via U/S.
 May become complicated by placenta accreta where the placenta
attaches to the uterus.

, Exam 4 SG OB

o Placenta previa can be complicated by:
a. Placenta accretta – attaches to the myometrium & slightly invades into it.
b. Placenta increta – invades further very deeply into the myometrium.
c. Placenta percreta – perforates through the myometrium.




o TREATMENT:
 Tocolytics – helps stop contractions.
 Corticosteroids (betamethasone) – give to mom at least 48 hrs. before
delivering the baby to help with lung maturity.
 Blood Transfusions.
 Bed rest & pelvic rest (no intercourse)
 C-section.
 Placental Abruption – detachment of placenta from uterine wall.
o 3 types:
 Partial
 Hidden
 Seen.
o Risk Factors:
 Trauma.
 Rapid loss of fluid (PROM).
 Previous abruption
 HTN – Preeclampsia.
 Substance abuse – esp. cocaine & meth.
 Advance maternal age.