A client who is 32 weeks pregnant presents to the emergency department with bright red bleeding and no abdominal pain. A nurse should:

A client who is 32 weeks pregnant presents to the emergency department with bright red bleeding and no abdominal pain. A nurse should:

• A. Assess the maternal blood pressure.
• B. Request an immediate ultrasound.
• C. Assess the fetal heart rate.
• D. Prepare for possible cesarean delivery.

Answer: (C)

In a pregnant patient with painless third-trimester bleeding, the priority is to assess fetal status to gauge the fetus’s well-being. Checking the fetal heart rate right away provides immediate information about whether the fetus is tolerating the bleeding and ongoing pregnancy. A reassuring fetal heart rate supports continued monitoring and guides further steps, such as ultrasound to locate the placenta and determine the need for delivery planning if bleeding recurs or worsens. If the fetal heart rate is nonreassuring, rapid escalation and coordinated management are needed. Maternal stability remains important, so monitoring blood pressure is also done, but it does not provide the quickest indication of fetal status in this scenario. An ultrasound to confirm placenta location would be valuable next, but the immediate, most informative action is assessing the fetal heart rate.

In a pregnant patient with painless third-trimester bleeding, the priority is to assess fetal status to gauge the fetus’s well-being. Checking the fetal heart rate right away provides immediate information about whether the fetus is tolerating the bleeding and ongoing pregnancy. A reassuring fetal heart rate supports continued monitoring and guides further steps, such as ultrasound to locate the placenta and determine the need for delivery planning if bleeding recurs or worsens. If the fetal heart rate is nonreassuring, rapid escalation and coordinated management are needed.

Maternal stability remains important, so monitoring blood pressure is also done, but it does not provide the quickest indication of fetal status in this scenario. An ultrasound to confirm placenta location would be valuable next, but the immediate, most informative action is assessing the fetal heart rate.