Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant?

A. Provide a sitz bath to a client who has a fourth-degree laceration and is 2 days postpartum: A sitz bath for a client with a fourth-degree laceration should be performed by the nurse or an experienced healthcare professional because it involves specific care to prevent infection and manage the laceration appropriately. It also requires assessment of the healing process, which is beyond the AP's scope of practice.

B. Change the perineal pad of a client who just transferred from labor and delivery: Changing a perineal pad is within the scope of the AP's role. This task involves basic hygiene care that can be safely delegated as it does not require clinical judgment or assessment.

C. Observe an area of redness on the breast of a client who is 1 day postpartum: Observing for signs of infection, such as redness on the breast, requires assessment and clinical judgment, which should be performed by the nurse, as it could be indicative of mastitis or other complications.

D. Monitor vital signs during admission of a client who has gestational hypertension: Monitoring vital signs is a task that can be delegated to the AP; however, given the potential for complications from gestational hypertension (such as preeclampsia), the nurse needs to be closely involved in assessing and managing the client's condition.

A. "Would you like a picture taken of your baby after birth?" While photographs can be a deeply meaningful keepsake for grieving parents, this is not the most immediate or sensitive first option to discuss. It should be offered later, after establishing emotional readiness and providing space for the parents to process the loss.

B. The nurse should not discuss any options at this time: plenty of time will be available after the baby is born. Delaying these conversations may deny the mother the chance to prepare emotionally and make informed decisions. Nurses must provide timely, compassionate guidance to help the family begin their grieving process in a supportive environment.

C. "When your baby is born, would you like to see and hold her?" This is the most appropriate and compassionate option. Offering the mother the chance to hold and say goodbye to her baby helps in the grieving process and fosters emotional closure. It recognizes the baby as a real person and the loss as significant, while allowing the parents control over their experience.

D. "What funeral home do you want notified after the baby is born?" Although necessary eventually, discussing funeral arrangements too soon may feel abrupt or insensitive. These logistics are best addressed after more emotionally supportive interactions have occurred and when the parents feel more prepared to make such decisions.