Final answer:
In a patient who has used cocaine and is in labor, the nurse should primarily assess for the complication of abruptio placenta due to cocaine's vasoconstrictive effects which can lead to reduced placental blood flow and fetal hypoxia.
Step-by-step explanation:
If a nurse is admitting a patient who is in labor and the patient admits to cocaine use, the nurse should assess for the complication of abruptio placenta. Cocaine use during pregnancy is associated with several fetal and maternal complications, one of which is placental abruption, or the premature separation of the placenta from the uterine wall. This can be a severe complication leading to fetal distress, preterm delivery, and even maternal hemorrhage. Cocaine's vasoconstrictive effects can cause reduced blood flow to the placenta, leading to hypoxia and possible abruptio placenta. Other possible complications include intrauterine growth restriction, spontaneous abortion, and central nervous system abnormalities.