After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests?

Choice A reason:

Lochial color changes from rubra to alba in the early postpartum period is a normal event. Lochia is the vaginal discharge that occurs after childbirth, and it progresses from bright red (rubra) to pink or brownish (serosa) to whitish-yellow (alba) as the days pass.

Choice B reason:

Extreme hunger and thirst in the early postpartum period may indicate abnormal blood sugar levels and can be a sign of gestational diabetes or other metabolic disorders. It requires further evaluation and monitoring by healthcare providers.

Choice C reason:

Diuresis (increased urination) and diaphoresis (increased sweating) are normal events in the early postpartum period. After childbirth, the body eliminates excess fluid that was retained during pregnancy, leading to increased urination and sweating.

Choice D reason:

Flatulence (passing gas) and constipation can be normal events in the early postpartum period due to the body recovering from the effects of labor, changes in diet, and the use of pain medications during childbirth.

Choice A reason:

A prolapsed umbilical cord occurs when the cord slips ahead of the presenting fetal part, potentially leading to cord compression and compromised fetal oxygenation. However, hypertonic contractions do not directly cause a prolapsed cord. Instead, factors such as premature rupture of membranes, abnormal fetal positioning, or excessive amniotic fluid (polyhydramnios) are more likely contributors to cord prolapse. Hypertonic contractions primarily affect uteroplacental circulation rather than fetal positioning.

Choice B reason:

One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because it produces a prolapsed cord. This is incorrect because a prolapsed cord is not caused by hypertonic contractions, but by other factors such as a low-lying placenta, a premature rupture of membranes, a small or preterm fetus, or an abnormal presentation. A prolapsed cord occurs when the umbilical cord slips through the cervix and into the vagina before or during delivery. This can compress the cord and cut off the blood supply to the fetus, resulting in fetal bradycardia and possible death.

Choice C reason:

One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because it increases maternal renal blood flow. This is incorrect because hypertonic contractions do not affect maternal renal blood flow directly. Maternal renal blood flow is influenced by factors such as maternal blood pressure, hydration, cardiac output, and renal function. Hypertonic contractions may cause maternal dehydration, which can reduce renal blood flow, but this is not a direct effect of oxytocin stimulation.

Choice D reason:

Hypertonic contractions reduce placental blood flow by limiting the relaxation phase between contractions. Normally, uterine contractions intermittently compress the spiral arteries supplying the placenta, but prolonged or excessively frequent contractions prevent adequate placental perfusion. This can lead to fetal hypoxia, acidosis, and distress, making it the most detrimental effect of oxytocin-induced hypertonic contractions.