The nurse is caring for a pregnant woman who is HIV positive. While teaching her about the use of antiretroviral drugs, the nurse explains that these medications will

A. Internal fetal monitoring. Internal fetal monitoring is contraindicated when placenta previa is suspected because it involves inserting a catheter or electrode into the uterus, which can increase the risk of hemorrhage if the placenta is covering the cervix.

B. Amniocentesis for fetal lung maturity. While fetal lung maturity assessment may be relevant if early delivery is being considered, it is not an immediate diagnostic procedure for evaluating the cause of vaginal bleeding. The priority is to determine placenta location and rule out placenta previa.

C. Contraction stress test. A contraction stress test evaluates fetal response to contractions but is not the appropriate initial diagnostic test in a patient with vaginal bleeding. Stimulating contractions could worsen bleeding if placenta previa or another placental abnormality is present.

D. Ultrasound for placenta location. The first-line diagnostic test for painless, bright red vaginal bleeding in the third trimester is an ultrasound. It helps determine whether the bleeding is due to placenta previa, a condition where the placenta partially or completely covers the cervix, which requires careful management to prevent complications.

A. Transverse fetal lie. A transverse fetal lie is related to fetal positioning and is not a direct complication of trauma. While maternal injuries can sometimes lead to abnormal fetal positioning, a car accident does not directly cause a transverse lie.

B. Preterm labor. Trauma, including a car accident, can trigger preterm labor due to stress, uterine irritation, or placental dysfunction. Uterine contractions may begin as a response to the injury, potentially leading to preterm birth.

C. Severe preeclampsia. Preeclampsia is not a direct result of trauma. It is a pregnancy-related hypertensive disorder that develops due to vascular abnormalities rather than external injury. A car accident does not increase the risk of preeclampsia.

D. Placenta previa. Placenta previa is a condition where the placenta covers the cervix, leading to painless vaginal bleeding, but it is not caused by trauma. It is a pre-existing placental abnormality rather than a complication of an auto accident.

E. Placental abruption. Trauma, such as a car accident, significantly increases the risk of placental abruption, where the placenta prematurely detaches from the uterine wall. This can cause vaginal bleeding, abdominal pain, and fetal distress, making it a critical complication to monitor for in a pregnant trauma patient.