A nurse is reinforcing dietary teaching with a client who has constipation about appropriate food choices. Which of the following food selections by the client demonstrates an understanding of the teaching?

Choice A reason: Difficulty swallowing isn’t a typical pain sign from epidural failure; it suggests throat or nerve issues unrelated to disc pain. Scientifically, this lacks connection to spinal analgesia efficacy, as herniated disc pain manifests elsewhere, not in pharyngeal function.

Choice B reason: Constipation may result from opioids in epidurals, not unrelieved pain. It’s a side effect, not a pain indicator. Scientifically, bowel changes reflect medication impact, not disc pain intensity, making this an unreliable marker for epidural effectiveness.

Choice C reason: Urinary retention is an epidural side effect from nerve blockade, not a direct pain signal. Scientifically, it indicates spinal anesthesia depth, not failure to relieve herniated disc pain, distinguishing it from pain-specific behavioral cues.

Choice D reason: Clenched teeth reflect facial tension, a common involuntary response to unrelieved spinal pain. Scientifically, this aligns with pain behavior studies, as muscle guarding and grimacing indicate persistent disc-related discomfort, signaling epidural inadequacy effectively.

Choice A reason: Persistent contractions signal labor or abruption, not previa. Placenta previa causes painless bleeding from placental positioning, not uterine activity.

Choice B reason: Increased fetal movement isn’t tied to previa; it’s a fetal response indicator. Previa’s hallmark is maternal bleeding, not fetal behavior changes.

Choice C reason: Rigid abdomen suggests abruption with clot formation, not previa. Previa bleeding is external, leaving the uterus soft, not tense.

Choice D reason: Bright red vaginal bleeding is classic in placenta previa, from low placental implantation. It’s painless, distinguishing it from other complications.