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 B
Explanation
Choice A rationale
Uric acid levels in preeclampsia can be elevated due to decreased renal clearance and increased production, often exceeding the normal range of 2.7 to 7.3 mg/dL. A value of 7.5 mg/dL is slightly elevated, which is a common finding in preeclampsia and does not typically contraindicate the administration of labetalol, an antihypertensive medication. It reflects disease progression but does not pose an immediate risk regarding medication administration.
Choice B rationale
Labetalol is a beta-blocker that reduces heart rate and blood pressure. A heart rate of 54/min is below the normal adult resting heart rate range (typically 60-100 beats/min) and indicates bradycardia. Administering labetalol to a client with pre-existing bradycardia could further depress the heart rate, potentially leading to symptomatic bradycardia, decreased cardiac output, and inadequate tissue perfusion, thus requiring the nurse to withhold the medication.
Choice C rationale
A fetal heart rate (FHR) of 112/min is within the normal range for a fetus (typically 110-160 beats/min). While labetalol can rarely cause fetal bradycardia, a baseline FHR of 112/min does not contraindicate its administration. The primary concern with labetalol in preeclampsia is the maternal hemodynamic response, and this FHR value does not indicate an immediate fetal distress that would preclude the medication.
Choice D rationale
A BUN level of 23 mg/dL is slightly elevated above the normal range of 10 to 20 mg/dL, often seen in preeclampsia due to impaired renal function. While this indicates renal involvement, it does not contraindicate the administration of labetalol. Labetalol is primarily metabolized by the liver, and while caution is advised in renal impairment, this BUN level alone does not warrant withholding the medication.
Correct Answer is ["C","D"]
Explanation
Choice C rationale
The client is tachycardic and has cool skin, indicating potential hypovolemia or shock due to excessive bleeding. Administering oxygen at 2 L/min via nasal cannula increases oxygen delivery to the tissues, improving cellular oxygenation and mitigating the effects of decreased circulating blood volume. This supports vital organ function and helps address tissue hypoxia, a common consequence of significant blood loss. Normal heart rate postpartum is 60-100 beats per minute.
Choice D rationale
Oxytocin is a uterotonic agent that stimulates uterine contractions. A boggy uterus and excessive bleeding are hallmark signs of uterine atony, the most common cause of postpartum hemorrhage. Initiating an infusion of oxytocin will promote uterine contraction, which compresses blood vessels and reduces blood loss, thereby addressing the underlying cause of the client's symptoms and preventing further hemorrhage. Normal lochia should be moderate in amount.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.