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A delirious client is admitted to the hospital in labor. She has had no prenatal care and vials of crack cocaine are found in her pockets.
The nurse monitors this client carefully for which of the following intrapartum complications?

A.

Prolonged labor.

B.

Prolapsed cord.

C.

Abruptio placentae.

D.

Retained placenta

E.

Retained placenta

Answer and Explanation

The Correct Answer is C

Choice A rationale

Prolonged labor is not directly linked to drug use and does not present as an immediate complication.

 

Choice B rationale

Prolapsed cord is not associated with substance abuse and lacks direct connection to this scenario.

Choice C rationale

Cocaine use heightens the risk of abruptio placentae, a serious condition where the placenta detaches prematurely.

 

Choice D rationale

Retained placenta is a concern but less likely than abruptio placentae in the context of cocaine use.


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Correct Answer is D

Explanation

Choice A rationale

Reduction of fever is not a primary effect of carboprost tromethamine. This medication is primarily used to induce uterine contractions to manage postpartum hemorrhage.

Choice B rationale

While maintaining stable blood pressure is important, it is not the specific indicator of carboprost tromethamine's effectiveness. This medication is used to control bleeding.

Choice C rationale

Increased comfort, although significant, is not the direct effect of carboprost tromethamine. The primary aim is to induce uterine contractions to manage hemorrhage.

Choice D rationale

Decreased lochia rubra indicates the reduction of postpartum bleeding, which is the primary purpose of administering carboprost tromethamine. This outcome shows the medication is effective.

Correct Answer is D

Explanation

Choice A rationale

Oxytocin is used to induce or augment labor, not typically used before an external version, which is a procedure to turn a breech baby to a head-down position.

Choice B rationale

Methylergonovine is used to prevent or control postpartum hemorrhage by inducing strong uterine contractions, not indicated before an external version.

Choice C rationale

Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not required for an external version.

Choice D rationale

Terbutaline is a tocolytic agent used to relax the uterus, making it easier to manipulate the fetus during the external version procedure.

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