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A 25-year-old in her third trimester of pregnancy is rushed to the hospital for abrupt, painless bright red vaginal bleeding. The physician diagnoses placenta previa after an ultrasound. The nurse's immediate care measures are:

Explanation

•To ensure an adequate blood supply to the woman and fetus, place the woman immediately on bed rest in a side lying position to relieve pressure of the vena cava.

•Things to check in the subsequent assessment:
-Duration of pregnancy
-Determine if there was accompanying pain
-Get estimate of blood loss and blood color
-Ask if other bleeding episodes occurred and preventative measures the patient took
-Ask if the patient had prior cervical surgery for premature cervical dilation

•After assessment, inspect the perineum and weigh perineal pads before and after use.

•Pelvic or rectal examination should not be done with painless bleeding late in pregnancy because any agitation of the cervix may initiate massive hemorrhage that is fatal to the mother and infant.

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