A nurse is conducting a health promotion class about the use of oral contraceptives. Which of the following disorders is a contraindication for oral contraceptive use?

Rationale:

A. "Remove a plug from the socket by pulling the cord": Yanking the cord can damage the cord, loosen wiring, and increase the risk of sparks or electrical fire. The correct method is to grasp the plug firmly and pull it straight out to avoid strain on the wire connections.

B. "Use three-pronged grounded plugs": Three-pronged plugs provide a grounding mechanism that reduces the risk of electric shock and fire. Grounded outlets redirect excess electricity safely into the ground if a fault occurs, making them a key part of electrical safety.

C. "Check for a tingling sensation around the cord": A tingling sensation can indicate an electrical short or exposed wiring, which is a serious safety hazard. While it’s important to report and stop using such cords, the focus should be on prevention before such issues arise.

D. "Cover extension cords with a rug": Covering cords with rugs can trap heat, cause insulation to wear down, and increase fire risk. Cords should be left uncovered and positioned to avoid foot traffic while maintaining ventilation to prevent overheating.

Rationale for Correct Answers:

1. Condition: Mastitis
Mastitis is an infection of the breast tissue that commonly affects breastfeeding women. It often occurs when bacteria (usually Staphylococcus aureus) enter through a cracked or damaged nipple, allowing pathogens to travel into the milk ducts. Symptoms can start with nipple pain and breast tenderness, progressing to flu-like symptoms, localized redness, and fever if untreated.

2. Evidence: Cracked nipple
The client's report of nipple discomfort throughout feeding and visible crack noted on the left nipple are red flags for potential bacterial entry, placing her at high risk for mastitis. Cracked nipples are common in breastfeeding, especially when there is poor latch or prolonged feeding.

Rationale for Incorrect Options:

Endometritis: This is an infection of the uterine lining. However, this client is 2 weeks postpartum, denies abdominal pain, and has normal lochial progression (whitish-yellow discharge = lochia alba). Her uterus is no longer palpable, indicating appropriate involution. No signs of fever, foul-smelling discharge, or uterine tenderness are noted.

Perineal hematoma: This would present with significant perineal pain, swelling, and possibly bluish discoloration. This client reports only mild perineal discomfort (2/10), likely related to normal healing from her episiotomy.

Group B streptococcus: The client tested negative for Group B Streptococcus. Moreover, GBS is not directly related to cracked nipples or mastitis.

Large for gestational age newborn: While the newborn was indeed LGA, this mainly increases the risk for perineal trauma or shoulder dystocia, not directly mastitis.