Which procedure is contraindicated for a client presenting with painless vaginal bleeding?

In cases of painless vaginal bleeding during pregnancy, a manual pelvic examination is contraindicated. The reason for this is that the presence of painless vaginal bleeding raises the suspicion of potential complications such as placenta previa, where the placenta is located low in the uterus and may cover the cervix. Performing a manual pelvic exam in such scenarios can increase the risk of triggering further bleeding or damaging the placenta, which could lead to serious complications for both the mother and the fetus.

In contrast, electronic fetal monitoring is a standard procedure to assess the fetal heart rate and well-being, and it is safe to perform without exacerbating bleeding. Likewise, a follow-up ultrasound can provide valuable information regarding placental location and fetal health without direct manipulation of the cervix. Additionally, digital cervical exams would introduce risks similar to those posed by a manual pelvic examination, so they are advised against in the context of painless vaginal bleeding due to the potential for causing harm.

Understanding the specific risks associated with painless vaginal bleeding is crucial for patient safety and appropriate management options.