A nurse is discussing nonpharmacological pain management during labor with a client.
Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale

Nausea is a very common, generally mild, and often transient side effect of oral contraceptives, usually caused by the estrogen component. It typically improves over a few cycles as the body adjusts to the hormonal changes and does not usually necessitate immediate notification of the healthcare provider.

Choice B rationale

Abdominal bloating is a frequent and minor adverse effect of hormonal contraception, often related to fluid retention or altered gastrointestinal motility due to hormonal fluctuation, which is usually self-limiting or manageable with minor adjustments, thus not requiring urgent reporting.

Choice C rationale

Breast tenderness or mastalgia is a common, dose-related side effect linked to hormonal stimulation (estrogen and/or progestin) of the mammary tissue, similar to premenstrual symptoms, and is generally considered a nuisance rather than an immediate danger sign.

Choice D rationale

Persistent headaches, especially if severe, unilateral, or associated with visual changes, can be a symptom of a serious adverse event like a cerebrovascular accident (stroke) or thrombotic events (e.g., cerebral venous thrombosis), which are rare but serious risks associated with hormonal contraceptives, necessitating immediate medical evaluation.

Choice A rationale

Hydrotherapy, like immersion in a tub or shower, is a nonpharmacological comfort measure for labor pain management. The therapeutic temperature of the water should indeed be maintained between 36 to 37°C (about 96.8 to 98.6°F). This range ensures the water is comfortably warm, promoting muscle relaxation, reducing pain perception, and avoiding potential maternal hyperthermia or fetal distress due to extreme temperatures.

Choice B rationale

Counterpressure is a technique used to relieve back pain caused by pressure of the fetal occiput against the sacrum, commonly known as "back labor.”. It involves steady, strong pressure applied by a support person to the sacral area or lower back, not the upper abdomen. Applying pressure to the upper abdomen would be ineffective and potentially uncomfortable for the client.

Choice C rationale

Effleurage is a light, rhythmic, stroking massage, often applied to the abdomen, used primarily during contractions in the first stage of labor to promote relaxation and distract from pain. It is generally not used during the pushing phase (second stage), as the client's focus shifts to bearing down and expelling the fetus, making effleurage distracting and ineffective.

Choice D rationale

Transcutaneous Electrical Nerve Stimulation (TENS) involves applying mild electrical currents via electrodes to the skin. During labor, the electrodes are typically placed on the lower back (sacral area) to block pain signals related to contractions as they travel up the spinal cord. Applying the TENS unit to the lower abdomen is not the standard placement for optimal labor pain relief.