Placenta Previa — NCLEX Cheat Sheet
Painless bright red bleedingAlso known as: low-lying placenta · placenta covering cervix · placenta over the opening
Use this quick-reference guide to spot, treat, and prevent Placenta Previa on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
📌 Define
- Placenta covers cervical os
- PAINLESS bright red bleeding
📌 Never
- NO vaginal exams (↑ hemorrhage)
- No sex, no rectal exams
✅ Do
- Bed rest, monitor bleeding/FHR
- Type & cross, large-bore IV
- C-section if complete previa
🚩 Report
- ↑ bleeding, ↓ BP, fetal distress
📚 Placenta Previa — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Bleeding is painless, bright red, and often sudden, typically after 20 weeks.
- The uterus remains soft and non-tender between bleeding episodes.
- Risk factors include prior cesarean or uterine surgery, multiparity, advanced maternal age, and multiple gestation.
- Fetal malpresentation (breech or transverse) is common because the placenta occupies the lower segment.
- Diagnosis is confirmed by transabdominal or transvaginal ultrasound, not by digital exam.
Nursing priorities
What to do, in order- Never perform a vaginal or digital cervical exam, as it can dislodge the placenta and cause massive hemorrhage.
- Monitor the amount and character of bleeding (pad counts, weights) and assess maternal vital signs for hypovolemia.
- Continuously monitor fetal heart rate and maintain the mother on bed rest as ordered.
- Establish IV access and have type-and-crossmatched blood available for possible transfusion.
- Prepare for cesarean birth, which is the planned delivery route for complete previa.
Red flags — report now
Escalate immediately- Report any vaginal bleeding immediately, even if it stops, as it can recur and worsen.
- Report signs of maternal shock (tachycardia, hypotension, pallor) or fetal distress.
- Never insert anything into the vagina, including exams, enemas, or intercourse, with a known previa.
Labs & values
Numbers to know- Hemoglobin: normal 12-16 g/dL (females); falls with blood loss
- Hematocrit: normal 36-46% (females)
- Blood type and Rh with crossmatch in case transfusion is needed
Patient teaching
What patients must know- Report any vaginal bleeding right away and avoid intercourse and tampons.
- Follow activity restrictions and avoid heavy lifting and strenuous exercise.
- Understand that a cesarean birth is likely if the placenta covers the cervix.
❓ Placenta Previa: NCLEX FAQs
What are the priority nursing interventions for Placenta Previa?
Never perform a vaginal or digital cervical exam, as it can dislodge the placenta and cause massive hemorrhage. Monitor the amount and character of bleeding (pad counts, weights) and assess maternal vital signs for hypovolemia. Continuously monitor fetal heart rate and maintain the mother on bed rest as ordered. Establish IV access and have type-and-crossmatched blood available for possible transfusion.
What are the warning signs of Placenta Previa a nurse must report?
Report any vaginal bleeding immediately, even if it stops, as it can recur and worsen. Report signs of maternal shock (tachycardia, hypotension, pallor) or fetal distress. Never insert anything into the vagina, including exams, enemas, or intercourse, with a known previa.
What do I need to know about Placenta Previa for the NCLEX?
Bleeding is painless, bright red, and often sudden, typically after 20 weeks. The uterus remains soft and non-tender between bleeding episodes. Risk factors include prior cesarean or uterine surgery, multiparity, advanced maternal age, and multiple gestation. Fetal malpresentation (breech or transverse) is common because the placenta occupies the lower segment.
What patient teaching is important for Placenta Previa?
Report any vaginal bleeding right away and avoid intercourse and tampons. Follow activity restrictions and avoid heavy lifting and strenuous exercise. Understand that a cesarean birth is likely if the placenta covers the cervix.
Quick Tip
Bleeding is painless, bright red, and often sudden, typically after 20 weeks.
📖 Related Topics
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