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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

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.

Correct Answer is B

Explanation

Choice A rationale

Retained tissue can cause postpartum hemorrhage, but with a firm uterus and no other signs of retained placenta, this is less likely the cause here.

Choice B rationale

Trauma is the most likely cause of increased bleeding in this scenario. The prolonged oxytocin induction and macrosomic infant suggest a higher risk of lacerations or uterine atony

despite the firm uterus.

Choice C rationale

Thrombin disorders cause bleeding due to clotting issues. However, this patient shows signs of active bleeding and clotting, making this less likely.

Choice D rationale

Uterine atony, indicated by a soft, boggy uterus, is a common cause of postpartum hemorrhage, but in this case, the uterus is firm, so it's less likely to be the cause.

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