Which action should be included in the plan of care on arrival for placenta previa?

• A. Continuous fetal monitoring and large-bore IV access.
• B. Bed rest and no monitoring.
• C. Immediate IV chemotherapy.
• D. Open the patient to full activity.

Answer: (A)

When placenta previa is present, the immediate priority is to protect both mother and fetus from potential hemorrhage and to be ready to respond quickly. Continuous fetal monitoring provides real-time information about the fetus’s well-being and any signs of distress or changes in uterine activity, which is crucial because bleeding can occur suddenly. Establishing large-bore IV access ensures rapid administration of fluids or blood products if bleeding occurs, enabling timely resuscitation. This combination addresses the most likely and potentially life-threatening scenario right away.

Other approaches fall short because they do not establish ongoing fetal assessment or rapid resuscitation capability. Bed rest with no monitoring leaves the fetus without real-time status updates. Immediate chemotherapy is irrelevant to placenta previa and unsafe in this context. Encouraging full activity would raise the risk of provoking or worsening bleeding.