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

Meconium stools are a normal physiological finding in a newborn during the first 24-48 hours of life. This thick, tarry, dark-green stool is composed of intestinal epithelial cells, amniotic fluid, bile, and water, reflecting fetal gastrointestinal tract development and function. Its presence indicates typical bowel activity.

Choice B rationale

Depressed fontanels indicate dehydration in a newborn. The fontanels are soft spots on a baby's head where the skull bones have not yet fused. When a baby is dehydrated, the fluid volume in the brain decreases, causing the fontanel to appear sunken below the normal contour of the skull, which necessitates immediate medical attention due to potential complications.

Choice C rationale

Rust-stained urine, also known as "brick dust" urine, in a newborn can indicate dehydration. This discoloration is caused by the excretion of urate crystals, which are a normal metabolic byproduct. However, in concentrated urine, these crystals become more visible, suggesting insufficient fluid intake and requiring further assessment to prevent significant dehydration.

Choice D rationale

Overlapping suture lines, also known as molding, are a common and expected finding in newborns, especially after vaginal delivery. This temporary reshaping of the fetal skull allows it to pass more easily through the birth canal and typically resolves spontaneously within a few days as the brain grows and fills the cranial cavity.