What is the priority action for a nurse admitting a client at 35 weeks of gestation with vaginal bleeding due to placenta previa?

The priority action for a nurse admitting a client at 35 weeks of gestation with vaginal bleeding due to placenta previa is to initiate continuous monitoring of the fetal heart rate (FHR). This is crucial because vaginal bleeding in the context of placenta previa can pose significant risks to both the mother and the fetus. Continuous FHR monitoring is essential to assess fetal well-being, detect any signs of fetal distress, and determine the immediate need for intervention.

Monitoring the FHR allows the healthcare team to promptly identify abnormal patterns that may indicate compromised blood flow or oxygen delivery to the fetus due to the bleeding. This proactive approach is necessary to ensure that any needed responses, such as preparing for an emergency cesarean delivery, can be implemented in a timely manner if the fetus shows signs of distress.

Other options, while also relevant in managing the overall situation, do not take precedence over the immediate need to ensure fetal monitoring in the presence of vaginal bleeding. For instance, administering betamethasone is beneficial for fetal lung maturity if preterm delivery is anticipated, but determining fetal status through monitoring comes first. Checking the cervix for dilation would not be appropriate as it could increase the risk of further bleeding, and misoprostol is typically not indicated in this scenario