A nurse is caring for a client who is about to undergo an amniotomy. What is the priority nursing action following this procedure?

Choice A rationale
Cocaine use is a risk factor for placental abruption, but it is not the most common one. Cocaine can cause vasoconstriction and decrease placental perfusion, leading to abruption.
Choice B rationale
Blunt force trauma, such as that from a car accident or physical violence, can cause placental abruption. However, it is not the most common risk factor.
Choice C rationale
Cigarette smoking is a risk factor for many pregnancy complications, including placental abruption. Smoking can impair placental function and lead to poor pregnancy outcomes.
Choice D rationale
Hypertension is the most common risk factor for placental abruption. High blood pressure can cause damage to the blood vessels in the placenta, leading to abruption.

Choice A rationale
Increased deposits of fat in the chest and shoulder area are not typically associated with respiratory distress syndrome in a term macrosomic newborn whose mother has poorly controlled type 2 diabetes.
Choice B rationale
Hyperinsulinemia is a condition in which there are excess levels of insulin circulating in the blood. In the case of a term macrosomic newborn whose mother has poorly controlled type 2 diabetes, the baby’s pancreas may produce extra insulin in response to the mother’s high blood glucose levels. This excess insulin can delay surfactant production, which is needed for lung maturation, leading to respiratory distress syndrome.
Choice C rationale
Brachial plexus injury is a type of birth injury that can occur due to the baby’s large size and difficulty being born. However, it is not the most likely cause of respiratory distress syndrome in a term macrosomic newborn whose mother has poorly controlled type 2 diabetes.
Choice D rationale

Increased blood viscosity can occur in newborns of mothers with poorly controlled diabetes due to polycythemia (an abnormally high number of red blood cells). However, this is not the most likely cause of respiratory distress syndrome in a term macrosomic newborn.