Prior to discharging a client who is 28 weeks gestation with a total placenta previa, the doctor calls and gives the nurse a phone order. Which order should the nurse question?

Question

a. Give 300 mcg of Rho(D) immune globulin prior to discharge (client is A-negative).
b. If contractions are present on fetal monitor, perform vaginal examination prior to discharging the client.
c. Instruct the client to monitor fetal activity daily until next office visit.
d. Perform nonstress test prior to discharge.

Answer 1

B
Vaginal examinations should be avoided for a client with total placenta previa. Giving 300 mcg of Rho(D) immune globulin prior to discharge (client is A-negative) is appropriate for this client, because she is Rh-negative and 28 weeks' gestation. Instructing the client to monitor fetal activity daily until next office visit is an appropriate prescription, because of the increased incidence of placental insufficiency with total placenta previa. Also, performing nonstress test prior to discharge is appropriate.