A nurse is planning care for a 4-hour-old newborn born to a client who has a prenatal history of substance use disorder. Which of the following interventions should the nurse include in the plan of care?

Choice A rationale

A boggy uterus indicates uterine atony, a leading cause of postpartum hemorrhage, as the uterus fails to contract effectively to compress blood vessels.

Choice B rationale

Moderate lochia rubra is expected postpartum vaginal bleeding, representing normal shedding of the uterine lining, not specifically indicating hemorrhage risk.

Choice C rationale

A first-degree perineal laceration is a minor tear that does not significantly increase the risk for postpartum hemorrhage as it usually involves limited bleeding.

Choice D rationale

Hypotension alone does not increase the risk for postpartum hemorrhage; however, it could be a result of ongoing hemorrhage rather than a cause.

Choice A rationale

Intraventricular hemorrhage (IVH) is a common complication of prematurity, but it is a neurological issue, not a primary respiratory anomaly.

Choice B rationale

Meconium aspiration syndrome (MAS) occurs when a newborn inhales meconium-stained amniotic fluid, leading to respiratory issues, more common in term or post-term infants.

Choice C rationale

Neonatal respiratory distress syndrome (NRDS) is a common respiratory anomaly in preterm infants due to insufficient surfactant production, causing alveolar collapse and impaired gas exchange.

Choice D rationale

Fetal lung hypoplasia, or underdeveloped lungs, can occur in various conditions but is not specifically a respiratory anomaly linked directly to prematurity.