A nurse is caring for a client who is 4 days postoperative following a right radical mastectomy. Which of the following activities should the nurse anticipate being the most difficult for this client to perform with her right hand?

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: "If your sexual partner has no symptoms, no medication is needed." This statement is false and misleading. Chlamydia is a sexually transmitted infection (STI) that can cause serious complications such as pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain if left untreated. Chlamydia can also be passed on to newborns during delivery, causing eye infections or pneumonia. Therefore, it is important that both the client and their sexual partner(s) receive treatment and abstain from sexual activity until they are cured.

Choice B: "This infection is treated with one dose of azithromycin." This statement is true and accurate. Azithromycin is an antibiotic that can effectively treat chlamydia with one oral dose. However, some people may experience side effects such as nausea, vomiting, diarrhea, or abdominal pain after taking azithromycin. Therefore, it is important that the client follows the instructions and completes the treatment as prescribed.

Choice C: "You need to return in 6 months for retesting." This statement is false and unnecessary. Retesting for chlamydia is recommended only if the client has symptoms, has a new or multiple sexual partner(s), or is pregnant. Otherwise, retesting is not required if the client and their partner(s) have completed the treatment and have no further exposure to chlamydia.

Choice D: "You have to avoid sexual relations for 3 days." This statement is false and insufficient. The client should avoid sexual relations until they and their partner(s) have completed the treatment and have no symptoms of chlamydia. This may take longer than 3 days, depending on the type and duration of the treatment. Therefore, it is advisable that the client uses condoms or abstains from sexual activity until they are cured.