A 38-week pregnant woman comes into the emergency department complaining of vaginal bleeding. The client is not in obvious distress or pain. Which statement by the client would lead the nurse to suspect placenta previa?
A 38-week pregnant woman comes into the emergency department complaining of vaginal bleeding. The client is not in obvious distress or pain. Which statement by the client would lead the nurse to suspect placenta previa?
A. "I don’t feel any pain at all. It’s just the bleeding that concerns me."
[86%]
B. "I feel like I’m about to go into labor. My tummy is starting to contract.”
[5%]
C. "I started bleeding when I picked up my 3-year-old son, who weighs 32 pounds."
[8%]
D. "I feel like I'm about to vomit."
[1%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Labor/Delivery
Client Need
Test Plan
Physiological Adaptation
Related Topic
Alterations in Body Systems
Item Type
Item Type
Application
Explanation
Choice A is correct. Placenta previa typically manifests as painless vaginal bleeding after 20 weeks gestation.
Choice B is incorrect. The client's statement's regarding contractions (including the implied pain associated with contractions) do not correlate with the symptoms of placenta previa. This client's comments would likely lead the nurse to assume this client is in early labor.
Choice C is incorrect. With placenta previa clients, bleeding is not necessarily correlated with lifting heavy objects.
Choice D is incorrect. Nausea is not typically associated with placenta previa. Typically, nausea is more common in early pregnancy than in late pregnancy.
Learning Objective
Associate a client's painless vaginal bleeding in the 38th week of pregnancy with a suspected diagnosis of placenta previa.
Related Videos
2 Key Topics
Placenta Previa
30.4 Intrapartum Complications
Additional Info
- Placenta previa occurs when the placenta implants over or near the internal os of the cervix.
- In clients with placenta previa, the source of bleeding is maternal.
- Diagnosis is performed by ultrasonography.
- Treatment is modified activity if minor vaginal bleeding occurs before 36 weeks gestation, with cesarean delivery at 36 to 37 weeks, 6 days.
- Immediate cesarean delivery is indicated if the bleeding is severe or refractory or if the fetal status is nonreassuring.
Source : Archer Review
