For a client diagnosed with total placenta previa, which finding should be reported immediately to the healthcare provider?

In the context of total placenta previa, the onset of uterine contractions is a critical finding that warrants immediate attention from the healthcare provider. Total placenta previa occurs when the placenta is positioned at or near the cervical opening, which can lead to severe complications, including significant bleeding as the cervix begins to dilate with contractions. The presence of contractions indicates that the uterus is becoming active, potentially putting the client at risk for complications such as hemorrhage or placental abruption.

Prompt reporting of contractions allows for timely assessment and intervention to ensure the safety of both the mother and the fetus. Monitoring the mother for signs of bleeding or changes in fetal heart tones is essential in this situation to prevent harm. The healthcare team may need to evaluate the need for hospitalization, additional monitoring, or even delivery, depending on the circumstances.

While other findings might also be relevant, such as increased heart rate or fetal heart variations, they do not pose an immediate threat requiring urgent intervention in the context of total placenta previa as the presence of contractions does. Therefore, recognizing and reporting the onset of uterine contractions is crucial in managing this high-risk pregnancy.