The nurse is providing discharge instructions to a person who was evaluated for possible labor. How does the nurse explain how losing the mucus plug could be a sign of impending labor?

Correct Answer: A

Rationale: Step-by-step rationale: 1. Increased estrogen levels lead to softening of the cervix, causing the mucus plug to be expelled. 2. Contractions usually start after the mucus plug is expelled, not before. 3. The mucus plug is typically expelled before the membranes rupture. 4. Effacement and dilation of the cervix prepare the body for labor but are not directly related to the expulsion of the mucus plug. In summary, Choice A is correct as increased estrogen leads to the expulsion of the mucus plug, indicating impending labor. Choices B, C, and D are incorrect as they do not accurately explain the relationship between the mucus plug and impending labor.

Correct Answer: C

Rationale: The correct answer is C: 1 hour for a multiparous person, 2 hours for a nulliparous person. This is based on the typical duration of the third stage of labor, which involves the delivery of the placenta. In general, the third stage is expected to last around 5-30 minutes. However, for safety reasons and to allow for variations in individual cases, it is recommended to extend the time frame to 1 hour for multiparous individuals (those who have given birth before) and 2 hours for nulliparous individuals (those giving birth for the first time). This extended time frame ensures that healthcare providers have enough time to monitor and intervene if necessary without rushing the delivery of the placenta. Other choices are incorrect because they provide either too short (A and B) or too long (D) timeframes for the third stage of labor, which could lead to inadequate monitoring or unnecessary interventions.

Correct Answer: D

Rationale: The correct answer is D because decreased progesterone, increased estrogen, and the effects of oxytocin are the hormonal changes that initiate labor. Progesterone inhibits contractions, so its decrease allows labor to begin. Estrogen promotes uterine sensitivity to oxytocin, which stimulates contractions. Oxytocin is released in response to labor contractions and helps to strengthen contractions. A: Incorrect because decreased progesterone is needed for labor to start, estrogen needs to increase, and oxytocin is present during labor. B: Incorrect because increased progesterone inhibits labor, estrogen should increase, and oxytocin is present during labor. C: Incorrect because progesterone should decrease, estrogen should increase, and oxytocin is present during labor.

Correct Answer: E

Rationale: Based on the scenario, the decrease in blood pressure post-placenta delivery indicates potential hemorrhage, a common complication. The nurse should assess for signs of bleeding, such as excessive vaginal bleeding or tachycardia. Prompt intervention is crucial to prevent further complications. Other choices are less relevant - pain alone does not directly cause a decrease in blood pressure, skin-to-skin contact is important but not the priority in this situation, and a distended bladder can be addressed later. Assessing for possible hemorrhage is the most critical action to take in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Prepare them for possible strains on relationships. This guidance is important as the arrival of a newborn can bring significant changes to the dynamics of a relationship. By preparing new parents for possible strains on relationships, the nurse can help them navigate challenges together. A: Incorrect. Roles are likely to change at home with the addition of a newborn, so it is important to address this rather than dismissing it. B: Incorrect. Stressors may actually increase with the arrival of a newborn, so it is not accurate to say stresses will be over. C: Incorrect. Ignoring household changes can lead to added stress, so it is not advisable to tell parents not to stress over them. In summary, option D is correct as it addresses the potential strains on relationships that new parents may face, while the other options do not acknowledge the reality of sociologic changes that can occur.