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Case study: Placenta Previa.

Candace Evans

Candace Evans is a 42 year woman admitted to the operating theatre at 38 weeks gestation for an elective lower uterine caesarean section (LUCS) under spinal anaesthesia. The patient has been diagnosed with Placenta Previa.

Pre-Operative Nursing Assessment:

Current History: Second pregnancy, 38 weeks gestation;

Past History: Gestational diabetes with her first pregnancy 5 years ago, which resolved following the birth with no recurrence in this pregnancy, depression, anxiety, post-natal depression.

You are working in the post anaesthetic recovery room (PACU) on a morning shift and will receive Candace following her LUCS. Candace arrives in the PACU, following the uneventful birth of a male infant via LUSC with APGARS of 8 at 1minute and 10 at 5 minutes following birth. Intraoperative blood loss was estimated at 150ml.

PACU Assessment:

Dermatome level T3;

Pain 0/10;

Lower uterine dressing dry and intact;

In-dwelling catheter with 100ml of rose coloured urine;

Intravenous therapy of Oxytocin in CSL running at 250mL/hour;

Vital Signs: HR 88, BP 104/76, SpO2 97% on RA, Temp 36.9° Celsius.

You pull the curtains to inspect for vaginal blood loss and find the patients vaginal pad to be soaked with frank blood and some clots. The midwife, new baby boy and patient’s partner wait patiently on the other side of the curtain.

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