A pregnant client diagnosed with placenta previa is admitted to the hospital. What is the most appropriate nursing intervention for this client?

Choice A rationale Performing frequent vaginal examinations is contraindicated in a client with known placenta previa due to the risk of placental trauma and precipitating severe hemorrhage. The placenta, positioned low and potentially covering the cervical os, is highly vascular. Digital manipulation could disrupt the fragile blood vessels at the placental-uterine interface, leading to life-threatening bleeding. Pelvic rest is mandatory for these patients. Choice B rationale Oxytocin is a uterotonic agent that stimulates strong uterine contractions. Administering it to a client with placenta previa could exacerbate the condition by intensifying the separation of the already low-lying placenta from the uterine wall during contractions, resulting in catastrophic hemorrhage and fetal distress. Tocolytics may be used for symptom control, but oxytocin is contraindicated. Choice C rationale Continuous electronic fetal heart rate (FHR) monitoring is essential to assess fetal oxygenation and well-being, as placental separation can compromise utero-placental perfusion. Concurrently, monitoring uterine contractions helps determine the onset and progression of labor, which dictates management, as contractions increase the risk of bleeding in this high-risk condition. Choice D rationale Encouraging ambulation is contraindicated because the mechanical pressure and movement could increase the risk of placental separation and initiate or worsen hemorrhage in the setting of placenta previa. Strict bed rest or modified bed rest is typically prescribed to minimize uterine activity and reduce the likelihood of bleeding, prioritizing maternal and fetal stability.