A first-time mother presents for a labor check.
She is informed that her vaginal exam shows dilated (3 cm), effaced (100%), and fetal station (-2). What explanation is the most appropriate response by the nurse?

Choice A rationale

Applying warm compresses before breastfeeding promotes vasodilation, increasing blood flow to the breast tissue. This facilitates milk let-down by relaxing the smooth muscles around the alveoli and ducts, making it easier for the infant to latch and nurse effectively, thereby relieving engorgement and associated pain.

Choice B rationale

Limiting fluid intake is contraindicated for breast engorgement. Adequate hydration is essential for maintaining milk production. Reducing fluids can lead to dehydration and potentially decrease milk supply, exacerbating engorgement and discomfort rather than alleviating it.

Choice C rationale

Applying cold compresses after breastfeeding helps to reduce inflammation and swelling in the breast tissue. The cold temperature causes vasoconstriction, which decreases blood flow and can minimize discomfort and engorgement by reducing tissue edema.

Choice D rationale

Frequent breastfeeding or regular pumping helps to remove milk from the breasts, which is the primary intervention for relieving engorgement. Regular emptying prevents milk from accumulating in the ducts and alveoli, reducing pressure and pain. This also helps establish and maintain milk supply.

Choice E rationale

Wearing a tight-fitting bra can restrict milk flow and increase pressure on the breast tissue, potentially worsening engorgement and causing discomfort. A supportive but not restrictive bra is recommended to provide comfort without impeding circulation or milk ducts.

Choice A rationale

Urinary tract infections primarily involve the urinary system, causing symptoms like dysuria, frequency, and urgency. While some overlap in symptoms might occur, the green-yellow vaginal discharge, itching, and foul odor are not typical of a UTI.

Choice B rationale

Trichomoniasis, caused by the parasite *Trichomonas vaginalis*, is a sexually transmitted infection that commonly presents with a frothy, green-yellow vaginal discharge, vulvar itching, and a distinct, often foul, odor. The client's recent unprotected sexual activity with new partners supports this possibility.

Choice C rationale

Herpes simplex virus typically causes painful vesicular lesions on the genitals, perineum, or cervix. While there might be some discomfort, the primary symptoms are the characteristic blisters, not typically a green-yellow discharge and foul odor.

Choice D rationale

Human papillomavirus (HPV) is a sexually transmitted infection that can cause genital warts or lead to cervical cancer. However, it typically does not present with a green-yellow vaginal discharge, itching, or a foul odor. Many HPV infections are asymptomatic. .