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?
Prolonged labor.
Prolapsed cord.
Abruptio placentae.
Retained placenta
Retained placenta
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 B
Explanation
Choice A rationale
While infection prevention is vital, ensuring breathing function is more critical after ASP.
Choice B rationale
ASP affects the respiratory system severely; thus, restoring normal breathing is a primary goal.
Choice C rationale
Gastrointestinal function is less immediately affected by ASP compared to respiratory issues.
Choice D rationale
Voiding without pain is important, but respiratory stability takes precedence.
Correct Answer is A
Explanation
Choice A rationale
Massaging the fundus can help contract the uterus and reduce bleeding. Ensuring IV access is crucial for administering medications rapidly. Methylergonovine (Methergine) and oxytocin help stimulate uterine contractions and reduce postpartum hemorrhage, which can be life-threatening.
Choice B rationale
Administering pain medication might be necessary, but it doesn't address the immediate issue of uterine atony and hemorrhage. Surgical intervention is a last resort and should be prepared for only if medical management fails.
Choice C rationale
Reassessing vital signs and monitoring is important, but it doesn't provide an immediate solution to the bleeding and uterine atony. Immediate action to contract the uterus is crucial.
Choice D rationale
Contacting the attending physician is important, but immediate intervention to stop the bleeding and address uterine atony is critical to prevent further complications.