A nurse is preparing to administer an opioid analgesic to a client who is in active labor.Which of the following assessments should the nurse perform? (Select all that apply.)

Choice A rationale

Variable decelerations are associated with umbilical cord compression, not placenta previa. In placenta previa, the placenta covers the cervical os, but it does not typically cause variable decelerations on fetal monitoring.

Choice B rationale

Painless vaginal bleeding is a hallmark sign of placenta previa. This occurs because the placenta is located near or over the cervical os, leading to bleeding when the cervix dilates or effaces.

Choice C rationale

A rigid abdomen is more indicative of placental abruption, where the placenta detaches prematurely from the uterine wall, causing pain and a tense abdomen, not typically seen in placenta previa.

Choice D rationale

Uterine tachysystole is characterized by excessive uterine contractions and is not a clinical finding related to placenta previa. Tachysystole often results from excessive oxytocin use or other uterine stimulants.

Choice A rationale

Methadone is often prescribed to pregnant women with opioid use disorder and is considered safe for breastfeeding. Breastfeeding can provide additional benefits such as bonding and transferring antibodies to the infant.

Choice B rationale

Methamphetamine use during pregnancy is linked to fetal growth restriction, preterm birth, and low birth weight, not fetal macrosomia (large body size).

Choice C rationale

Reducing environmental stimuli is essential for neonates exposed to substances in utero. Increased stimuli can overwhelm their underdeveloped nervous systems, leading to stress and adverse outcomes.

Choice D rationale

Fetal alcohol syndrome is characterized by growth deficiencies, facial abnormalities, and central nervous system dysfunction. An increased head circumference is not a typical feature; rather, microcephaly (small head circumference) is more common.