The nurse expects to administer an oxytocic (e.g., Pitocin) to a woman after expulsion of her placenta to:

Choice A rationale

Heartburn, or pyrosis, is often caused by the relaxation of the lower esophageal sphincter (LES) due to pregnancy hormones like progesterone and the upward pressure from the enlarging uterus. Substituting other calcium sources for milk is not a primary intervention because milk, while sometimes a temporary buffer, does not address the underlying mechanical and hormonal causes of acid reflux.

Choice B rationale

Fiber-rich foods promote bowel regularity and are essential during pregnancy to prevent constipation, a common discomfort. Reducing fiber is an inappropriate suggestion for managing heartburn; instead, the focus should be on dietary modifications that lessen gastric reflux, such as avoiding spicy or acidic foods.

Choice C rationale

Eating five small meals daily prevents the stomach from becoming overly distended, which is a key contributor to pushing stomach contents, including acid, back up into the esophagus through the relaxed LES. Smaller, more frequent meals, along with maintaining an upright posture after eating, are effective non-pharmacological methods to manage reflux discomfort.

Choice D rationale

Lying down after meals is strongly discouraged for individuals experiencing heartburn, particularly in late pregnancy. The recumbent position allows gravity to assist the reflux of stomach acid into the esophagus, which will intensify the burning sensation. The woman should remain upright for at least two to three hours following food consumption.

Choice A rationale

Oxytocics are primarily smooth muscle stimulants that act on the uterine fundus to cause firm, sustained contractions. While a contracted uterus helps prevent bacterial entry into open blood vessels, the primary purpose of oxytocics after birth is mechanical, not antimicrobial, and therefore they are not administered to prevent infection.

Choice B rationale

Oxytocics stimulate intense uterine contractions, which can be uncomfortable or painful for the woman. They are administered for physiological necessity, not to facilitate rest or relaxation; analgesics or other supportive measures are used for those goals.

Choice C rationale

Oxytocin stimulates powerful contractions of the myometrium, which causes the uterus to clamp down on the blood vessels that supplied the placenta. This contraction is vital for mechanically compressing the uterine blood vessels at the placental site, which prevents or controls postpartum hemorrhage due to uterine atony.

Choice D rationale

Oxytocin administration causes strong uterine cramping as the uterus contracts, which can actually increase postpartum pain. Pain relief is managed through methods like analgesics, not through the administration of an oxytocic agent, which is a key pharmacological intervention to reduce bleeding.