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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

Checking blood sugar is important in gestational diabetes but isn't immediate priority in a triage setting compared to assessing urgent conditions that could harm the fetus or mother immediately.

Choice B rationale

Assessing vaginal blood loss post-abortion is crucial, but in the presence of ruptured membranes, fetal heart rate checks take precedence to ensure the fetus's immediate well-being.

Choice C rationale

Assessing patellar reflexes in pre-eclampsia management is significant, but immediate priority in labor and delivery triage goes to ensuring fetal safety after membrane rupture.

Choice D rationale

Checking the fetal heart rate after membrane rupture is a priority because it provides immediate information about the fetus's status and any potential complications like cord prolapse or distress.

Correct Answer is D

Explanation

Choice A rationale

Placing a pacifier in the baby's mouth is inappropriate because it does not address the underlying cause of grunting, which can be a sign of respiratory distress.

Choice B rationale

Checking the baby's diaper is not relevant to assessing the cause of grunting. Grunting is usually related to respiratory issues rather than a dirty diaper.

Choice C rationale

Having the mother feed the baby is inappropriate because grunting may indicate respiratory distress. Feeding should be deferred until the baby's respiratory status is assessed and stabilized.

Choice D rationale

Assessing the respiratory rate is appropriate because grunting in a newborn can indicate respiratory distress. The nurse should evaluate the respiratory status to determine the need for further intervention.

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