A nurse in a healthcare provider’s office is caring for a patient who is at 34 weeks of gestation and at risk for placental abruption.

 The nurse should recognize that which of the following is the most common risk factor for abruption? 

Choice A rationale
Missing a menstrual cycle and reporting vaginal spotting could indicate early pregnancy or other non-emergency conditions. While this client should be evaluated, it is not the highest priority.
Choice B rationale
A client at 28 weeks of gestation reporting painless vaginal bleeding could be experiencing placenta previa or placental abruption, both of which are obstetric emergencies. This client should be prioritized for immediate evaluation.
Choice C rationale
A client at 38 weeks of gestation reporting symptoms of a cough and fever may have an upper respiratory infection. While this should be evaluated, it is not the highest priority unless the client is in distress.
Choice D rationale
Nausea and vomiting are common in early pregnancy. A client at 14 weeks of gestation reporting these symptoms would need evaluation, but it is not the highest priority.

Choice A rationale
Preparing the abdominal and perineal areas is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. This type of bleeding is suggestive of placenta previa, a condition where the placenta covers part or all of the cervix, preventing normal delivery. While preparing the abdominal and perineal areas may be necessary in preparation for delivery, it is not the immediate priority.
Choice B rationale
Initiating IV access is the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. This type of bleeding is suggestive of placenta previa, a condition where the placenta covers part or all of the cervix, preventing normal delivery. IV access allows for rapid administration of fluids and medications, which may be necessary to stabilize the client’s condition.
Choice C rationale
Inserting an indwelling urinary catheter is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. While a urinary catheter may be necessary in preparation for delivery or surgery, it is not the immediate priority.
Choice D rationale
Witnessing the signature for informed consent for surgery is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. While obtaining informed consent may be necessary before performing certain procedures or surgeries, it is not the immediate priority.