A nurse is providing client teaching regarding an intrauterine device (IUD). Which of the following statements should the nurse include in the teaching?
You might have to have cultures for sexually transmitted infections prior to placement of the device.
The device will have to be replaced every 2 years.
You might experience irregular spotting the first few months after placement of the device.
You will need to avoid using tampons during menstrual cycles.
You will need to sign informed consent prior to the procedure.
Correct Answer : A,C,E
Choice A rationale
Prior to IUD insertion, screening for sexually transmitted infections (STIs) is crucial to prevent the introduction of pathogens into the upper reproductive tract. An untreated STI, particularly chlamydia or gonorrhea, can lead to pelvic inflammatory disease (PID) when an IUD is placed, as the device might facilitate the ascent of bacteria.
Choice B rationale
The duration of effectiveness for intrauterine devices varies depending on the type. Hormonal IUDs typically last for 3 to 8 years, while copper IUDs can remain effective for up to 10 years. Therefore, the statement that the device must be replaced every 2 years is incorrect and misleading for most available IUDs.
Choice C rationale
Irregular spotting and changes in menstrual bleeding patterns are common side effects during the initial months following IUD placement, particularly with hormonal IUDs. This is due to the local endometrial effects of progesterone release or the inflammatory reaction induced by copper, as the uterus adapts to the foreign body.
Choice D rationale
There is no medical contraindication to using tampons with an IUD. The IUD resides in the uterus, while tampons are inserted into the vaginal canal. There is no physical interaction or risk of dislodgement of the IUD by tampon use. Clients can continue their preferred menstrual hygiene products.
Choice E rationale
Informed consent is a fundamental ethical and legal requirement before any medical procedure, including IUD insertion. The client must be provided with comprehensive information regarding the procedure, including its benefits, risks, alternatives, and potential side effects, to make an autonomous and voluntary decision.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Relying solely on facial recognition of staff members is an insufficient and potentially dangerous security measure. Hospital staff members can change shifts, and imposters might attempt to abduct newborns. Robust security protocols, such as mandatory identification badges and alarm systems on infant security tags, are designed to prevent unauthorized individuals from leaving the unit with an infant, providing a more reliable defense against abduction.
Choice B rationale
The instruction to remove a newborn's microchip identification band after arriving home is inaccurate and potentially misleading. Hospitals typically use infant security tags or bands that are removed by staff upon discharge, not by the parents at home. These bands are crucial for preventing abductions within the facility by triggering alarms if an infant is taken beyond designated boundaries.
Choice C rationale
Personally carrying a newborn to the nursery, especially without supervision or adherence to facility protocols, increases the risk of abduction. Hospitals often require staff to transport infants in bassinets or cribs, typically with two staff members present, to minimize opportunities for unauthorized individuals to gain access to or abduct a newborn. This procedure enhances infant safety significantly.
Choice D rationale
Bringing the newborn in the bassinet into the bathroom with the mother maintains constant direct observation and reduces the risk of abduction. This strategy minimizes the time the infant is left unattended, preventing opportunities for an abductor to seize the child. Maintaining proximity and direct line of sight is a fundamental principle of infant security in a hospital environment.
Correct Answer is ["B","C"]
Explanation
Choice A rationale
Meconium stools are a normal physiological finding in a newborn during the first 24-48 hours of life. This thick, tarry, dark-green stool is composed of intestinal epithelial cells, amniotic fluid, bile, and water, reflecting fetal gastrointestinal tract development and function. Its presence indicates typical bowel activity.
Choice B rationale
Depressed fontanels indicate dehydration in a newborn. The fontanels are soft spots on a baby's head where the skull bones have not yet fused. When a baby is dehydrated, the fluid volume in the brain decreases, causing the fontanel to appear sunken below the normal contour of the skull, which necessitates immediate medical attention due to potential complications.
Choice C rationale
Rust-stained urine, also known as "brick dust" urine, in a newborn can indicate dehydration. This discoloration is caused by the excretion of urate crystals, which are a normal metabolic byproduct. However, in concentrated urine, these crystals become more visible, suggesting insufficient fluid intake and requiring further assessment to prevent significant dehydration.
Choice D rationale
Overlapping suture lines, also known as molding, are a common and expected finding in newborns, especially after vaginal delivery. This temporary reshaping of the fetal skull allows it to pass more easily through the birth canal and typically resolves spontaneously within a few days as the brain grows and fills the cranial cavity.
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