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: Trichomoniasis is not the correct answer because it does not match the findings of the client. Trichomoniasis is a sexually transmitted infection (STI) caused by a parasite called Trichomonas vaginalis. It can cause symptoms such as yellow-green or gray frothy vaginal discharge, foul odor, itching, burning, or redness of the vulva or vagina.

Choice B: Genital herpes simplex is not the correct answer because it does not match the findings of the client. Genital herpes simplex is an STI caused by a virus called herpes simplex virus (HSV). It can cause symptoms such as painful blisters or ulcers on or around the genitals, fever, headache, or swollen lymph nodes.

Choice C: Candidiasis is the correct answer because it matches the findings of the client. Candidiasis is a fungal infection caused by a yeast called Candida albicans. It can cause symptoms such as thick, white, cottage cheese-like vaginal discharge, intense itching, burning, or soreness of the vulva or vagina, or dyspareunia (painful sexual intercourse).

Choice D: Bacterial vaginosis is not the correct answer because it does not match the findings of the client. Bacterial vaginosis is a condition caused by an imbalance of the normal vaginal flora (the bacteria that live in the vagina). It can cause symptoms such as thin, gray-white or yellow vaginal discharge, fishy odor, itching, or burning of the vulva or vagina.

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.