75. A client, who is a 38-year-old gravida 4, para 2, has an ultrasound at 34 weeks' gestation, which reveals a marginal placenta previa. The client has some bright red spotting, but no contractions or abdominal pain. A nurse should anticipate that the expected management for a client with marginal placenta previa will be:
. Limiting activity to bedrest, with bathroom privileges.
. Preparing for an immediate cesarean delivery.
. Doing a contraction stress test for fetal well-being.
. Inducing labor with misoprostol.
Test-Taking Tip
Visualize a placenta previa, marginal placenta previa, and partial placenta previa. The varying extent of the placenta covering over the cervix will determine the management.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Planning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Alterations in Body Systems
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Answer 1 is correct because, since the client is not having significant active bleeding, the pregnancy can safely be extended by limiting activity to bedrest with bathroom privileges. Answer 2 is incorrect because there is no immediate need to perform a cesarean section delivery. The client is hemodynamically stable and can be managed by bedrest. Answer 3 is incorrect because a contraction stress test for fetal well-being would be contraindicated in a client with marginal placenta previa. Contractions can lead to increased vaginal bleeding. A nonstress test is the appropriate test for fetal well-being in a client with marginal placenta previa. Answer 4 is incorrect because induction of labor with misoprostol would be contraindicated in a client with a marginal placenta previa. Contractions can lead to increased vaginal bleeding and fetal distress.