A nurse is assessing a client who is in active labor. The client reports back labor pains.
Which of the following nonpharmacological interventions should the nurse provide to manage the client's pain?

Choice A rationale

Epigastric pain in a pregnant client, especially at 33 weeks gestation, can be a symptom of preeclampsia, a serious hypertensive disorder of pregnancy. This pain may indicate hepatic involvement and impending eclampsia, requiring immediate medical evaluation to prevent severe maternal and fetal complications.

Choice B rationale

Leukorrhea, an increase in vaginal discharge, is a common physiological finding during pregnancy due to increased estrogen levels and blood flow to the vaginal area. It is typically thin, white, and odorless, and does not generally require reporting unless accompanied by itching, odor, or color changes.

Choice C rationale

Excessive salivation, or ptyalism, is a common and benign complaint during pregnancy, often attributed to hormonal changes. While bothersome, it does not indicate a pathological condition and is not a finding that requires reporting to the provider.

Choice D rationale

Darkening of the skin on the face, known as chloasma or melasma gravidarum, is a normal physiological change in pregnancy caused by increased melanin production due to hormonal fluctuations. It is a cosmetic issue and not indicative of a medical concern requiring provider notification.

Choice A rationale

Feeding from the affected breast is crucial for promoting milk drainage and preventing milk stasis, which can exacerbate mastitis. Emptying the breast, even if painful, helps to clear the blocked ducts and reduce the bacterial load. Discontinuing feeding from the affected breast could lead to engorgement and worsening of the infection, hindering recovery.

Choice B rationale

Pumping and discarding milk is not recommended for mastitis. The milk from a breast with mastitis is generally safe for the infant, and the act of pumping helps to empty the breast and facilitate drainage, similar to direct breastfeeding. Discarding the milk unnecessarily deprives the infant of nutrition and can contribute to decreased milk supply.

Choice C rationale

Applying moist heat to the affected breast can significantly alleviate discomfort and promote milk flow by causing vasodilation and encouraging ductal patency. This helps to reduce inflammation, improve circulation, and facilitate the drainage of milk from the breast, which is essential for resolving the infection and reducing pain.

Choice D rationale

Maintaining adequate hydration is important for overall health, especially during lactation. However, a specific fluid intake of exactly 1,500 milliliters per day is not the primary or most effective intervention for mastitis. While hydration supports milk production, the core interventions for mastitis focus on milk drainage, pain management, and often antibiotic therapy.