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

Choice A: Fluid balance is not the most likely priority because it is not directly affected by the mastectomy. Fluid balance is the state of equilibrium between the intake and output of fluids in the body. It can be influenced by various factors such as hydration, nutrition, medication, or illness. It can be monitored by measuring vital signs, weight, urine output, or laboratory values. Fluid balance is important for maintaining homeostasis and preventing dehydration or edema, but it is not a specific concern for a client undergoing a mastectomy.

Choice B: Body image is the most likely priority because it is directly affected by the mastectomy. Body image is the perception and attitude that one has toward one's own physical appearance and function. It can be influenced by various factors such as culture, media, self-esteem, or feedback from others. It can be assessed by observing verbal and nonverbal cues, asking open-ended questions, or using standardized tools. Body image is a major psychosocial issue for a client undergoing a mastectomy, as it can affect one's sense of identity, femininity, sexuality, or attractiveness. The nurse should address body image by providing information, support, and referral to appropriate resources.

Choice C: Urinary elimination is not the most likely priority because it is not directly affected by the mastectomy. Urinary elimination is the process of expelling urine from the bladder through the urethra. It can be influenced by various factors such as fluid intake, kidney function, medication, or infection. It can be assessed by measuring urine volume, color, odor, or specific gravity. Urinary elimination is important for maintaining fluid balance and preventing urinary tract infection or retention, but it is not a specific concern for a client undergoing a mastectomy.

Choice D: Activity is not the most likely priority because it is not directly affected by the mastectomy. Activity is the level of physical movement and exercise that one engages in on a daily basis. It can be influenced by various factors such as age, health status, motivation, or environment. It can be assessed by observing mobility, endurance, strength, or coordination. Activity is important for maintaining muscle tone, joint range of motion, circulation, or metabolism, but it is not a specific concern for a client undergoing a mastectomy.

Choice A: Sporadic vaginal bleeding accompanied by chronic pelvic pain is not the correct answer because it is not a symptom of cystocele or rectocele. This symptom may indicate other conditions such as endometriosis, fibroids, or cervical cancer.

Choice B: Menstrual irregularities and hirsutism on the chin are not the correct answers because they are not symptoms of cystocele or rectocele. These symptoms may indicate other conditions such as polycystic ovary syndrome (PCOS), thyroid disorder, or menopause.

Choice C: Heavy leukorrhea with vulvar pruritus is not the correct answer because it is not a symptom of cystocele or rectocele. This symptom may indicate other conditions such as bacterial vaginosis, yeast infection, or sexually transmitted infection (STI).

Choice D: Stress incontinence with a feeling of low abdominal pressure is the correct answer because it is a symptom of cystocele or rectocele. Stress incontinence is a condition that causes leakage of urine when there is increased pressure on the bladder, such as during coughing, sneezing, laughing, or lifting. Cystocele or rectocele can cause stress incontinence by weakening the pelvic floor muscles and connective tissue that supports the bladder and urethra. The feeling of low abdominal pressure is also a symptom of cystocele or rectocele, as it indicates that the bladder or rectum is protruding into the vagina.