3rd ROTATION CLINICAL DUTY  EDD: APRIL 12, 2022\

 FH:: 37 CM, FHT: 145 PER MINUTE

- MRS. NORMA ORNEDO
 3rd trimester – 7,8,9 months
 DOCTOR’S ORDER: BLOOD TYPING,CBC
 NPO- for emergency CS if the bleeding
will not stop
 D5LR 30 DROPS PER MINUTE (IVF)

First do the leopolds maneuver

 HISTORY OF PRESENT ILLNESS
CASE

3RD TRIMESTER G1P1 FEMALE 32 WEEKS AOG

CONSULTED AT ZIGA DISTRICT
VAGINAL BEEDING DUE TO PLACENTAL
MEMORIAL HOSPITAL
PROBLEMS.
ACCOUMPANIED BY HER MOTHER
PLACENTA PRIVIA
CC: MODERATE VAGINAL BLEEDING FOR
PLACENTAL ABRUPTION 2 DAYS BUT NO LABOR PAIN, ADVICED
CC: VAGINAL BLEEDING FOR 2 DAYS, FOR ADMISSION
MODERATE
 NONE PREVIOUS HOSPITAL
NURSING HEALTH HISTORY:  FAMILY HISTORY ALL NEGATIVE
 NO ALLERGIES
 PATIENT X
 COMPLICATION OF BLEEDING FOR 3RD
 FEMALE
TRIMESTER IS DUE TO PLACENTAL
 23 YO
PROBLEMS
 MARRIED
 PLACENTA PRIVIA – LOW
 2, 24, 2022 IMPLANTATION OF THE PLACENTA IN
 9 PM THE LOWER INTERNAL CERVICAL
 ROMAN CATHLIC -PARTIAL AND COMPLETE
 HOUSE WIFE - NOT TOTALLY COVERED, TOTALLY
 DR WARD OR LABOR ROOM COVERED THE CERVIX
 CC: MODERATE VAGINAL BLEEDING FOR
2 DAYS UTERINE FACTORS: POOR
 AD: G2P1 VASCULARITY ( weak musclesof the
 32 WEEKS AOG OR 7 OR 8 MONTHS uterus), FIBROID TUMORS, MULTIPLE
 FD: PLACENTA PRIVIA WTH 32 WEEKS PREGNANCY.
AOG
 VITAL SIGNS: BP-100/70, PR: 88, RR: 23, ASSESSMENT FOR PLACENTA PRIVIA
PER MINUTE, W-67 KLG, H- 155 CM, T- - Painless but there is bleeding
36.8 - Uterus is remained soft
 LMP: JULY 5, 2021
 - Fht- stable unless mother will be in placentae, also called placental abruption,
shock due to bleeding. typically present with bleeding, uterine
- No IE because it will worsen the contractions, and fetal distress.
bleeding and will put the mother and
UTERINE FACTORS: LATE
baby in risk
PREGNANCIES
- Incase of bleeding, emergency CS is
done

Nursing INTERVENTION:
NURISNG INTERVENTION:
 Advice mother for complete  ENSURE COMPLETE BED REST
bed rest  IV FLUID
 NPO  CHECK THE MATERNAL AND
 Position the mother in side lying FETAL VS EVERY 15 MINUTES
or trentelurge position for 72 
hours, or sitting position to
compress the placenta.
 Monitor the fetal status
 NO IE
 Keep the IV fluid (explain to the
mother why the IV fluid is
necessary for to the situation)
 Gauge 18 needle is used for IV
fluid for OB
 Monitor the mother, maternal
and fetal VS every 15 minutes

ABRUPTIO PLACENTA- separation of the

placenta, it occurs in 20 weeks of pregnancy,
accompanied by pain.

The uterus is tender, FHT is weak, fetal

bradicardia, there is sometimes an absence of
FHT, mother may be in shock due to bleeding.

Placenta previa (placenta is near or

covers the cervical opening) Placental
abruption (placenta detaches
prematurely from the uterus)

Abruptio placentae is defined as the

premature separation of the placenta
from the uterus. Patients with abruptio