성장을 멈추지 마세요

체험은 만족하셨나요?

현재 45,773명이 마이메르시로 공부 중이에요

지식 자료를 소장하고 멋진 의료인으로 성장하세요

학습 자료 둘러보기 →
Placenta Previa | 마이메르시 MyMerci
제안하기

뭔가 하고 싶은 말이 있는거야?

0 / 2000
컨텐츠 수정하기

컨텐츠 내용을 수정할 수 있습니다

수정하기
닫기

Placenta Previa

NCLEX Review Guide: Placenta Previa

Definition and Classification

Understanding Placenta Previa

  • Placenta previa occurs when the placenta implants in the lower uterine segment, partially or completely covering the cervical os. This condition affects approximately 1 in 200 pregnancies and poses significant risks for both mother and fetus.
  • Classification includes complete previa (placenta completely covers cervical os), partial previa (placenta partially covers os), and marginal previa (placental edge reaches cervical os).

Memory Aid: "LOW PLACEMENT"

Low implantation
Obstructs cervical opening
Warning sign: painless bleeding

Key Points

  • Diagnosed via ultrasound, never by vaginal examination
  • May resolve as uterus grows (placental migration)
  • Higher risk with advanced maternal age and multiparity

Clinical Manifestations and Assessment

Signs and Symptoms

  • Classic presentation includes painless, bright red vaginal bleeding typically occurring in the second or third trimester. The bleeding may be intermittent and range from light spotting to severe hemorrhage.
  • Critical Alert: Fetal heart rate may remain normal initially, but maternal and fetal compromise can occur rapidly with significant bleeding episodes.

Clinical Scenario

A 32-year-old G3P2 at 28 weeks gestation presents with sudden onset of painless, bright red vaginal bleeding. Vital signs: BP 110/70, HR 88, fetal heart rate 140s with good variability. What is the priority nursing action?

Answer: Do NOT perform vaginal examination - obtain IV access and prepare for ultrasound

Key Points

  • Bleeding episodes may stop spontaneously but often recur
  • Uterus typically soft and non-tender (unlike placental abruption)
  • Malpresentation common due to placental location

Nursing Management and Interventions

Immediate Care Priorities

  1. NEVER perform vaginal examination - can precipitate massive hemorrhage
  2. Establish large-bore IV access and obtain blood for type and crossmatch
  3. Position client on left side to optimize placental perfusion
  4. Continuous fetal and maternal monitoring
  5. Administer oxygen if indicated and prepare for emergency delivery

Memory Aid: "NO FINGERS"

No vaginal exams
Oxygen and IV access
Fetal monitoring
Immediately notify physician
Nothing per vagina
Get blood ready
Emergency cesarean prep
Rest and monitor
Side-lying position

Key Points

  • Pelvic rest essential - no intercourse, tampons, or douches
  • Corticosteroids given if delivery likely before 34 weeks
  • Cesarean delivery typically required for complete previa

Commonly Confused Concepts

Placenta Previa vs. Placental Abruption

Characteristic Placenta Previa Placental Abruption
Bleeding Painless, bright red Painful, dark red
Uterine tone Soft, relaxed Firm, rigid, tender
Onset Gradual, may stop/start Sudden, continuous
Fetal status Often stable initially Frequently compromised

Key Points

  • Remember: Previa = Painless, Abruption = Agonizing pain
  • Both require immediate medical intervention
  • Both contraindicate vaginal examination initially

Study Tips and Quick Checks

NCLEX Success Strategies

Priority Nursing Actions Sequence

1. Assess bleeding and vital signs
2. Position client appropriately
3. Establish IV access
4. Continuous monitoring
5. Prepare for delivery

Common Pitfalls to Avoid

  • Never assume bleeding will stop permanently
  • Don't delay emergency preparations
  • Remember that mild bleeding can become severe quickly
  • Always consider fetal lung maturity in management decisions

Quick Check Questions

  • ☐ Can you explain why vaginal exams are contraindicated?
  • ☐ Do you know the difference between complete and partial previa?
  • ☐ Can you identify priority nursing interventions?
  • ☐ Do you understand when cesarean delivery is necessary?

Remember: You're preparing to save lives! Every concept you master brings you closer to becoming the compassionate, competent nurse your patients will need. Stay focused, trust your preparation, and believe in yourself! 💪

다음 이론을 계속 학습하려면 로그인하세요.

로그인하고 계속 학습
컨텐츠를 그만볼래?

필기노트, 하이라이터, 메모는 잘 쓰고 있어?

내보내줘
어떤 폴더에 저장할래?

컨텐츠 노트에는 총 0개의 폴더가 있어!

폴더 만들기
컨텐츠 만들기
만들기
신고했어요.

운영진이 검토할게요!

해당 유저를 차단했어요.

마이페이지에서 차단한 회원을 관리할 수 있어요.