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Which is the priority nursing care for a client at 38 weeks' gestation, admitted with the diagnosis of placenta previa?

a. Withholding oral intake
b. Assessing for hemorrhage
c. Avoiding extraneous stimuli
d. Encouraging supervised ambulation.

1 Answer

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Final answer:

The priority nursing care for a client at 38 weeks' gestation with placenta previa is assessing for hemorrhage, which is the primary complication of this condition.

Step-by-step explanation:

For a client at 38 weeks' gestation admitted with the diagnosis of placenta previa, the priority nursing care is assessing for hemorrhage. Placenta previa is a condition where the placenta partially or completely covers the cervical opening, leading to potential antepartum hemorrhage, which can be life-threatening to both the mother and fetus. It is crucial to monitor the client for any signs of vaginal bleeding, as well as to maintain a calm environment and prepare for potential interventions should hemorrhage occur. Other considerations such as withholding oral intake may be necessary if there's a risk of surgery, but they are not the primary focus.

It is also pertinent to avoid digital cervical examinations, which can provoke bleeding. The obstetrician may need to examine the expelled placenta post-delivery to ensure no fragments remain, as retained placental fragments can cause postpartum hemorrhage. Additionally, practices like breastfeeding can aid in the process of involution, returning the uterus to its pre-pregnancy size and function.

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