Midwifery.

Sample Solution

Antepartum Hemorrhage (APH)

Antepartum hemorrhage (APH) is vaginal bleeding that occurs after the 24th week of pregnancy and before birth. It's a serious complication that can affect both mother and baby.

Classification of APH:

• Placenta Previa: The placenta implants abnormally low in the uterus, partially or completely covering the cervix.
• Placental Abruption: Premature separation of a normally situated placenta from the uterine wall.
• Other Causes: These include cervical lesions, uterine rupture, placental marginal separation, and vasa previa (blood vessels crossing the cervix).
• Unexplained APH: Sometimes, no specific cause can be identified.

Nursing Management of Placental Abruption

Since you mentioned abruption placenta, here's the nursing management for that specific case:

• Fetal assessment: Monitor fetal heart rate and movement continuously to assess fetal well-being.
• Maternal vital signs: Closely monitor vital signs (blood pressure, pulse, respiration) for signs of shock.
• Blood tests: Monitor blood count and clotting studies to identify blood loss and potential need for transfusion.
• Uterine tone: Assess uterine tone for signs of continued bleeding or contractions.
• Pain management: Administer pain medication as prescribed to improve patient comfort.
• Emotional support: Provide emotional support and information to the patient and her family.
• Prepare for delivery: Depending on the severity of abruption and fetal status, prepare for immediate delivery (cesarean section) or expectant management.

Full Answer Section

Antenatal Teaching for Primigravida with APH

• Explain APH: Briefly explain what APH is and the different causes.
• Importance of immediate medical attention: Emphasize the importance of seeking immediate medical attention if any vaginal bleeding occurs during pregnancy.
• Warning signs: Educate the patient about warning signs like abdominal pain, contractions, decreased fetal movement, or heavy bleeding.
• Risk factors: Discuss potential risk factors for APH, such as smoking, high blood pressure, or previous uterine surgery.
• Importance of rest: Advise getting plenty of rest and avoiding strenuous activity as recommended by the doctor.
• Maintain open communication: Encourage the patient to ask questions and express any concerns she may have.

Remember: This information is for educational purposes only. Always consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.