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?

Choice A rationale

Reporting abnormal findings to the obstetrician is unnecessary because an increase in the Bishop score from 4 to 10 indicates successful cervical ripening and readiness for labor induction.

Choice B rationale

Placing the client on her side is not directly related to the assessment of cervical ripening or the Bishop score. It may be considered for comfort during labor.

Choice C rationale

Monitoring for the onset of labor is appropriate since the increase in the Bishop score to 10 suggests that the cervix is favorable for labor. Continuous monitoring is essential to detect the onset and progression of labor.

Choice D rationale

Performing nitrazine analysis of amniotic fluid is not relevant to the assessment of cervical ripening or the Bishop score. This test is typically used to confirm the presence of amniotic fluid in cases of suspected rupture of membranes.

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.