If a client at 28 weeks gestation presents with bright red vaginal bleeding but no contractions or pain, what should the nurse instruct her to do?

In the context of bright red vaginal bleeding at 28 weeks gestation without contractions or pain, the most appropriate guidance for the client is to come to the clinic for an ultrasound. This recommendation is crucial because it allows for timely assessment of the situation. An ultrasound can help determine the cause of the bleeding, whether it is due to placenta previa, placental abruption, or other complications.

Monitoring the condition is essential, and while immediate evaluation is warranted, it does not necessarily require an emergency room visit if the patient is stable and asymptomatic aside from the bleeding. The clinic can perform the necessary imaging studies and evaluations to ensure both maternal and fetal well-being in a controlled environment. Furthermore, remaining calm and seeking appropriate care can help mitigate unnecessary anxiety in the client.

In this scenario, simply instructing to lie on the left side is helpful for improving blood flow but does not address the need for medical evaluation. Going immediately to the emergency room would typically be reserved for severe cases where immediate intervention may be necessary. Lastly, waiting to bring a urine specimen the next day does not prioritize the need for evaluation of the current obstetric condition, especially in the context of active bleeding.