The mother is diagnosed with partial placenta previa. The nurse tells the client that the usual treatment for partial placenta previa is?

Appeared in: BCCL kharkhanda Staff Nurse - 2015

Explanation

Partial placenta previa is a condition where the placenta partially covers the internal cervical os.
For a stable patient with minimal or no bleeding and a preterm fetus, the standard approach is conservative or 'expectant management' to prolong the pregnancy.
Bed rest is a key component of this conservative management. It aims to reduce physical activity and uterine irritability, thereby minimizing the risk of provoking a bleeding episode.
This approach allows the fetus more time to mature in utero, improving neonatal outcomes.

Option B: Platelet administration is not a standard treatment for placenta previa. Coagulopathy is a rare complication of this condition.
Option C: An immediate caesarean section is an emergency procedure, not the 'usual' treatment for a stable patient with partial placenta previa.
Option D: Inducing labor with oxytocin is strictly contraindicated in placenta previa.

Clinical Relevance

Nursing practice connection: Use the key finding related to Management of Partial Placenta Previa to guide bedside assessment, documentation, and the next nursing action.
The primary nursing responsibility is to monitor the patient for any signs of vaginal bleeding, assess its amount and character, and continuously evaluate fetal well-being through heart rate monitoring.
Patient education is critical. The nurse must explain the importance of strict bed rest and pelvic rest (no intercourse, no vaginal exams) to prevent bleeding.
Nurses must ensure emergency preparedness, including maintaining IV access, having cross-matched blood readily available, and being ready to prepare the patient for an emergency caesarean section at a moment's notice.

How to Approach the Question

First, identify the clinical diagnosis provided in the question stem: 'partial placenta previa'.
Recall the primary risk associated with this condition, which is painless, bright red vaginal bleeding, especially in the second or third trimester.
Understand the main goal of management in a stable patient: to prolong the pregnancy safely to allow for fetal lung maturity.
Evaluate each option based on this goal. 'Bed rest' is a conservative measure aimed at preventing bleeding and prolonging pregnancy.
Analyze the other options: 'Immediate caesarean section' is for emergencies, not usual care. 'Administration of platelets' is for a specific complication (coagulopathy), not routine. 'Induction of labour with oxytocin' is dangerous and contraindicated.
Conclude that bed rest is the most appropriate 'usual treatment' among the choices for a stable patient.

Concept Tested & Keywords

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E6 Obstetrics Williams pp. 72-95, 68-93

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Attempt every question from this paper in a timed mock, then review the full solution for each one.