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

place the woman on bed rest in a side-lying position


• 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 on 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 what preventative measures the patient took
    • Ask if the patient had prior cervical surgery for premature cervical dilation

• After an assessment, inspect the perineum and weigh perineal pads before and after to monitor blood loss.

• Incorrect: 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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