A laboring client received meperidine IV one hour prior to delivery. Which of the following medications should the nurse have available to counteract the effects of this medication on the newborn?

Choice A rationale:

Increased pancreatic activity during pregnancy causing fat intolerance is not related to the cause of indigestion and heartburn. Pancreatic activity can change during pregnancy, but it does not directly impact indigestion and heartburn.

Choice B rationale:

Increased estrogen production causing more hydrochloric acid in the stomach is not the cause of indigestion and heartburn during pregnancy. While hormones can influence digestion, the mechanism for indigestion and heartburn lies elsewhere.

Choice C rationale:

Pressure from the growing uterus pushing up on the stomach and intestines is a contributing factor to indigestion and heartburn during pregnancy. However, it is not the primary cause. The main cause is related to the relaxation of the cardiac sphincter.

Choice D rationale:

Progesterone causes relaxation of the cardiac sphincter, which is a muscular valve that prevents stomach acid from flowing back into the esophagus. When this sphincter relaxes, it can lead to acid reflux and subsequent indigestion and heartburn during pregnancy. The nurse should educate the client about this hormonal effect to help manage these symptoms effectively.

Choice A rationale:

The client is experiencing continuous abdominal pain and vaginal bleeding, which are key signs of abruptio placentae. This condition occurs when the placenta prematurely separates from the uterine wall before the baby is born, leading to bleeding and potential fetal distress. The history of cocaine use can be a risk factor for abruptio placentae, as cocaine use may lead to vasoconstriction and reduced blood flow to the placenta.

Choice B rationale:

Hydatidiform mole is not likely in this case because it presents with symptoms such as vaginal bleeding and a "grape-like” mass on ultrasound. The continuous abdominal pain is not typical for a hydatidiform mole.

Choice C rationale:

Preterm labor is not the likely complication in this scenario because the client is at 38 weeks of gestation, which is considered full term. Preterm labor refers to labor that occurs before 37 weeks of gestation.

Choice D rationale:

Placenta previa is not the likely complication as it presents with painless vaginal bleeding in the third trimester, and the abdominal pain described in the question suggests a different condition.