The nurse reviews results of a 28 week fetal ultrasound that reveals a small for gestational age fetus and a low implanted placenta.
The nurse will plan teaching for which pregnancy complication?

Choice A rationale

While exploring other client problems is a component of holistic care, it is not the most immediate and direct priority after a major decision like continuing pregnancy. The primary focus should shift to practical support and preparation for the forthcoming maternal role and necessary resources, ensuring safety and continuity of care.

Choice B rationale

Giving explicit approval is non-therapeutic and can interfere with the client's autonomy and decision-making process. The nurse's role is to provide nonjudgmental, supportive care and information, respecting the client's choice without imposing personal values or moral judgments on the situation.

Choice C rationale

Making an appointment is a practical step, but providing information about resources empowers the adolescent to navigate the complex healthcare system and social support networks independently, which is a broader and more enabling intervention for long-term self-care and success.

Choice D rationale

Providing information about resources and assistance, such as WIC, Medicaid, and parenting classes, directly addresses the practical and socio-economic challenges inherent in an adolescent pregnancy. This is essential for promoting positive maternal-fetal outcomes and self-efficacy in the client's chosen path.

Choice A rationale

Preparing for an immediate cesarean birth is not the initial priority; assessment is needed first to confirm the diagnosis, determine the degree of placental involvement, and evaluate maternal-fetal status. A cesarean birth is indicated only if bleeding is heavy or the fetus is distressed, not automatically upon admission.

Choice B rationale

A vaginal examination is strictly contraindicated as a priority action when painless, bright red vaginal bleeding occurs late in the second trimester, as this is the classic sign of placenta previa. Such an examination could cause a catastrophic hemorrhage by disturbing the placental site.

Choice C rationale

An ultrasound assessment is the priority to non-invasively confirm the diagnosis of placenta previa, determine the precise placental location relative to the cervical os, and assess fetal well-being, including estimated weight and amniotic fluid volume. This diagnostic step guides all subsequent safe management decisions.

Choice D rationale

Assessment of uterine contractions using an Intrauterine Pressure Catheter (IUPC) is an invasive procedure requiring ruptured membranes, which is not indicated upon admission for suspected placenta previa. External tocodynamometry is used for contraction monitoring, and the IUPC is reserved for specific labor management situations.