ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATION

SUBJECTIVE: Profuse bleeding may Abruptio placenta is is Giving midwife Gathering of patient’s Data gathering for Midwife intervention
 Profuse bleeding compensate on separation of the intervention to patient data. comparison of past given to patient in
and abdominal patient’s vital signs placenta (the organ that in order to reduce and present data. order to reduce
cramps for 3 days. like hypotension, nourishes the fetus) from bleeding, abdominal bleeding, abdominal
tachycardia, the site of uterine cramps, and improve Place the patient in Sidelying position cramps, and improve
OBJECTIVE: tachypnea, and implantation after 20 and/or stabilize sidelying position. promote optimum and/or stabilized health
 IE: 3cm dilated hypotermia that may weeks of gestation and health condition. placental prefusion. condition.
cervix, intact BOW, reflect as before delivery of the
cephalic hypovolemic shock. fetus. It is also called After giving midwife Insert a foley catheter. Foley catheter for After giving midwife
presentation ablatio placenta, intervention, the accurate record of intervention, the
 Vital signs: Profuse bleeding may placental abruption, and patient will report for urine output and patient was able to
BP: 60/50 mmhg lead to anemia. accidental hemorrhage. any signs of should be at least 30 report for any signs of
PR: 100 bpm discomfort, bleeding, cc per hour. discomfort, bleeding,
RR: 40 bpm Abdominal cramps is Abruptio placenta is and abdominal and abdominal
BT: 35.6 °C caused by abdominal thought to be caused by cramps. Put patient on NPO NPO until reasonable cramps.
 Paleness of the expanding and/or degenerative changes in status. stability is assured and
skin ligaments stretching. the spiral arteriols that possibility of
 Excessive bleeding ultimately reduce the immediate cesarean
 Cold o clammy skin Profuse bleeding with blood supply to the delivery is concluded.
abdominal cramps decidua, resulting in
and not normal vital necrosis of deciduous Provide oxygen therapy Oxygen therapy
signs is possibly tissues and blood using a nasal cannula at proves oxygen supply
related and be vessels, rupture of blood 4 to 6 liters. both to mother and
diagnose abruptio vessels, bleeding fetus.
placenta. occurs, and blood
collects between the Observe and record the Perineal pad absorb
decidua and placenta amount and time of approximately 60 to
from the ruptured bleeding at least every 100 ml of blood.
vessels. This blood 30 minutes or more Weigh perineal pad
collection induces often if necessary. Use before and after use
increased pressure saturated perineal pad. for accurate
against the placenta, assessment of vaginal
which drives the bleeding.
placenta further and Assess the status of
further apart, thereby abdomen. Assessment provides
increasing the degrees baseline information
of placental separation whether the abdomen
from the decidua. is board-like, tender,
or soft.
The blood flow from the Mark the fundus of the
uterus to the placenta is uterus for increase in Observe for any
cut off when the fundal height. sudden increase in
placenta separates from fundal height
the uterus, preventing indicationg a
the proper exchange of concealed bleed.
substances between the Monitor vital signs and
placenta and the uterus, manifestation of shock. Gathering the patient’s
which contributes to vital signs for
depriving the fetus of the comparison of past
requisite oxygen and and present data and
nutrients. Intrauterine for planning of giving
growth retardation the proper
(IUGR), fetal discomfort, intervention.
and hypoxia result from Assess uterine
chronic poor placental contractions. When placenta is
perfusion as the fetus is separated from the
no longer adequately uterus, prostaglandin
nourished and supplied is released, which can
with oxygen. cause contractions.
Blood typing and cross
Causes of apbruptio matching, have at least In case of severe
placenta may cause of 3 to 4 units of blood. hemorrhage, whole
maternal hypertension, blood contains clotting
advanced maternal age, factors and provide the
grand multiparity, trauma volume that is needed.
to uterus, rapid Administer IVF: Ringer
decompression of an Lactate, 125 cc per IVF for rapidly replace
over-distended uterus, hour. blood lost
short umbilical cord,
uterine leiomyoma or Use a warmer
fibroids, and behavioral attachment. To prevent chilling and
risk factors like cigarette fall in the maternal
smoking, core temperature.
metamphetamine and Accurately chart fluid
cocaine abuse, and intake (IVF). To prevent fluid over
maternal alcohol load
consumption. Ultrasound is
necessary. To differentiate
The manifestation of abruptio placenta and
signs and symptoms placenta previa, and
may vary depending on know other possible
the type of abruptio abnormalities or
placenta or the manner complications.
of separation like in
vaginal bleeding, Monitor fetal condition To monitor the heart
abdominal pain, board by daily nonstress test rate and movement of
like abdomen, and signs and kick counts. the fetus for intervene
of shock and fetal in the birth process.
distress.
Administer prescribed For controlling vaginal
tocolytic medication by bleeding and uterine
doctor. contractions.

Observe for signs of To give proper

DIC. intervention and
medication in order to
prevent or control
bleeding

Inform patient and To encourage patient

provide emotional and and increase trust to
psychosocial support. midwives and other
 health professional.

Advise diet rich in iron. Iron is a mineral

carries oxygen in the
hemoglobin of red
blood cells throughout
the body so cells can
produce energy.

Advise intake of Vitamin Vitamin C improves

C. intestinal iron
absorption.

Increase in fiber intake Minimize constipation

and straining which
could precipitate
vaginal bleeding.

Watch out for Mother may bleed

hemorrhage. profusely and suffer
from postpartum
hemorrhage,
additional intervention
is needed.

Provide oxytocin, gentle To ensure that the

 massage, and close patient’s uterus
monitoring after remains firm.
delivery.
To prevent infection
Teach patient proper and contamination of
hygiene, perineal care, the vagina with rectal
and instruct the patient bacteria.
to change her pads and
thoroughly wash her
hands.
Medicine will be given
Encourage patient to according to doctor’s
report hemorrhage and order to reduce
pains with scale hemorrhage and pain.
intensity from 1 to 10.
To go over any
Encourage patient to potential medication
have follow-up visit 1 changes and know
week after hospital health improvements
discharge.

GROUP 1: CAMPOSANO, CIELO, EDEM, IBALIN, RODRIGUEZ