A nurse is caring for a patient who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads in the past 30 minutes.

The nurse suspects placenta previa.

What would be an appropriate nursing action in this situation?

Choice A rationale
Estrogen is a hormone that plays a crucial role in pregnancy. It helps develop the placenta and triggers increased blood volume and flow throughout pregnancy. However, it is not the primary hormone responsible for maintaining pregnancy.
Choice B rationale
Oxytocin is a hormone that plays a key role in labor and breastfeeding. It causes contractions during labor and helps eject milk during breastfeeding. However, it is not the primary hormone responsible for maintaining pregnancy.
Choice C rationale
Human chorionic gonadotropin (hCG) is a hormone produced during pregnancy. It is made almost exclusively in the placenta and its main function is to maintain the corpus luteum in the ovary and stimulate it to produce progesterone. However, hCG itself is not the primary hormone responsible for maintaining pregnancy.
Choice D rationale
Progesterone is the primary hormone responsible for maintaining pregnancy. It prevents the uterine muscles from contracting prematurely, which could lead to a miscarriage or preterm birth.

Choice A rationale
Preeclampsia is a condition that can occur during pregnancy, characterized by high blood pressure and signs of damage to another organ system, often the liver and kidneys. If a patient is experiencing preeclampsia, the nurse should initiate seizure precautions, as seizures can occur in severe cases. The nurse should also monitor the patient’s neurological status and liver function studies, as these can be affected by preeclampsia.
Choice B rationale
Hypertension, or high blood pressure, can occur during pregnancy, but the actions listed do not fully address the condition. While bed rest was once commonly recommended for high blood pressure during pregnancy, research has not shown it to be effective. Monitoring blood pressure and heart rate is important, but other interventions, such as medication, may also be necessary.
Choice C rationale
Gestational diabetes is a condition characterized by high blood sugar that develops during pregnancy. Insulin may be administered to help control blood glucose levels. The nurse should monitor blood glucose levels and fetal heart rate, as gestational diabetes can affect both the mother and the baby. However, the condition the patient is most likely experiencing, given the gestational age and symptoms, is preeclampsia.
Choice D rationale
Preterm labor refers to labor that begins before the 37th week of pregnancy. Tocolytics may be administered to slow or stop contractions. The nurse should monitor the contraction pattern and cervical dilation to assess for progression of labor. However, the condition the patient is most likely experiencing, given the gestational age and symptoms, is preeclampsia.