A client has painless vaginal bleeding at 35 weeks' gestation and is scheduled for an ultrasound to confirm a diagnosis of placenta previa
In addition to monitoring the client's vital signs and fetal heart rate, nursing management of this client would include: a. preparation for immediate cesarean delivery
b. frequent vaginal examinations
c. bed rest with bathroom privileges if no bleeding occurs
d. administration of antibiotics and antiemetics
C
Placenta previa occurs when implantation occurs in the lower uterine segment. The classic symptom is painless bleeding in the last half of pregnancy. There may be occasional bright red spotting or intermittent gushes of blood. Ultrasound is used to diagnose placenta previa. The goal is to maintain the pregnancy until the fetus is mature enough to survive. The client is hospitalized if bleeding occurs, and hemoglobin and hematocrit are determined every 12 hours. Vaginal exams should not be performed by the nurse. If the condition becomes severe or fetal distress occurs, a cesarean section is needed.
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