A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug?

Choice A: Vaginal pH of 3 is not the correct answer because it is not a finding of bacterial vaginosis. Vaginal pH is a measure of how acidic or alkaline the vaginal environment is. A normal vaginal pH ranges from 3.8 to 4.5, which helps prevent infections by maintaining a balance of healthy bacteria (lactobacilli). Bacterial vaginosis can cause an increase in vaginal pH above 4.5, which allows harmful bacteria (anaerobes) to grow and cause symptoms.

Choice B: Cervical bleeding on contact is not the correct answer because it is not a finding of bacterial vaginosis. Cervical bleeding on contact is a sign of inflammation or injury to the cervix, which is the lower part of the uterus that connects to the vagina. It can be caused by various factors such as infection, trauma, or cancer. Bacterial vaginosis does not affect the cervix directly, but it can increase the risk of other infections or complications that may cause cervical bleeding.

Choice C: Fishy odor of discharge is the correct answer because it is a finding of bacterial vaginosis. The fishy odor of discharge is a characteristic symptom of bacterial vaginosis that occurs due to the breakdown of organic compounds (amines) by the anaerobic bacteria. The odor is usually more noticeable after sexual intercourse or during menstruation.

Choice D: Yellowish-green discharge is not the correct answer because it is not a finding of bacterial vaginosis. Yellowish-green discharge is a sign of infection or inflammation of the vagina or cervix, such as trichomoniasis, gonorrhea, or chlamydia. These infections can cause symptoms such as itching, burning, or pain in the genital area. Bacterial vaginosis usually causes a thin, gray-white, or milky discharge that does not cause irritation or discomfort.

Choice A: Growth spurt is not the correct answer because it is not the first event that occurs in female puberty. The growth spurt is a period of rapid increase in height and weight that usually occurs between 10 and 14 years of age in girls. It is influenced by various factors such as genetics, nutrition, and hormones. Growth spurt usually follows the development of breast buds and pubic hair by about 6 to 12 months.

Choice B: Evidence of pubic hair is not the correct answer because it is not the first event that occurs in female puberty. Evidence of pubic hair is the appearance of coarse, curly, and pigmented hair on the pubic area and around the genitals. It usually occurs between 8 and 13 years of age in girls. It is caused by the increased production of androgens (male hormones) by the adrenal glands and ovaries. Evidence of pubic hair usually follows the development of breast buds by about 3 to 6 months.

Choice C: Onset of menses is not the correct answer because it is not the first event that occurs in female puberty. The onset of menses is the beginning of menstrual cycles, which are regular changes in the female reproductive system that prepare the body for pregnancy. It usually occurs between 10 and 15 years of age in girls. It is caused by the maturation of the hypothalamus, pituitary gland, ovaries, and uterus, which regulate the levels of estrogen and progesterone (female hormones). The onset of menses usually follows the development of breast buds and pubic hair by about 2 to 3 years.

Choice D: Development of breast buds is the correct answer because it is the first event that occurs in female puberty. Development of breast buds is the enlargement and elevation of the nipples and areolas (dark circles around the nipples), which indicate the beginning of breast growth. It usually occurs between 8 and 12 years of age in girls. It is caused by the increased production of estrogen (female hormone) by the ovaries, which stimulates the growth of ducts (tubes) and lobules (glands) in the breast tissue. The development of breast buds is also called thelarche or breast stage 2.