A nurse is providing teaching to an antepartum client who has a new diagnosis of genital herpes simplex virus 2 (HSV-2). Which of the following information should the nurse include?

Choice A rationale

Skin mottling, characterized by a patchy, net-like, reddish-blue discoloration of the skin, is typically caused by vasoconstriction in response to cold exposure or by circulatory changes in individuals with poor peripheral perfusion. This is not a typical, expected body change during a normal pregnancy; expected skin changes relate more to hyperpigmentation (e.g., chloasma, linea nigra).

Choice B rationale

During pregnancy, hormonal changes, particularly the increase in estrogen, shift a greater proportion of hair follicles into the anagen (growth) phase, leading to thicker, fuller hair. Hair thinning (telogen effluvium) is commonly experienced postpartum when hormone levels drop and the hair follicles shift rapidly back into the telogen (resting) phase, thus it is not expected at 14 weeks gestation.

Choice C rationale

Nipple inversion is a structural variation where the nipple is retracted into the areola; it is not a change that typically develops during pregnancy. Expected breast changes include areolar darkening (hyperpigmentation), prominent Montgomery's tubercles, and nipple erection. Nipple inversion is a pre-existing condition that may present challenges for breastfeeding.

Choice D rationale

Breast enlargement (hypertrophy) is an expected and early body change during pregnancy, beginning in the first trimester (around 6 weeks). This growth is driven by elevated estrogen and progesterone levels, stimulating the development of the mammary glands in preparation for lactation, and is often accompanied by tenderness and increased vascularity.

Choice A rationale

The umbilical cord stump typically dries, shrivels, and spontaneously separates from the infant's abdomen due to a process similar to dry gangrene (ischemic necrosis) within one to three weeks after birth; therefore, this statement indicates correct understanding of the normal timeline for cord care and healing.

Choice B rationale

A newborn's skin is sensitive and prone to drying, and daily tub baths are unnecessary and may cause skin irritation; sponge baths are used until the cord stump falls off, and then typically only two to three baths per week are recommended initially to maintain skin integrity.

Choice C rationale

The correct procedure for using a bulb syringe is to compress the bulb before insertion into the mouth (or nose) to create the negative pressure, then release the compression slowly to suction mucus; compressing it after insertion would expel air into the baby's mouth instead of suctioning.

Choice D rationale

Placing a baby on their side to sleep increases the risk of the baby rolling onto their stomach, which is associated with an elevated risk of Sudden Infant Death Syndrome (SIDS); the universally recommended safe sleep position is supine (on the back).