A nurse is reinforcing teaching with a client who is being fitted for a contraceptive diaphragm. Which of the following information should the nurse include?

A. Replace the device once per year. The diaphragm should be replaced every 2 years, not every year, unless it becomes damaged or the client's body changes significantly.

B. Replace the device every 3 years. The diaphragm is generally replaced every 2 years, not 3 years.

C. Replace the device after a 20% weight loss. Significant weight changes, such as a 20% weight loss or gain, may alter the fit of the diaphragm, making it less effective. It should be refitted or replaced after such changes.

D. Replace the device after a urinary tract infection. There is no need to replace a diaphragm after a UTI unless it is damaged or no longer fits properly. UTIs are a common side effect of diaphragm use due to its impact on the urethra.

Post-Test Answers Requiring Follow-Up:

Latex condoms should be used with oil-based lubricants. Oil-based lubricants can degrade latex condoms, increasing the risk of breakage. Water-based or silicone-based lubricants should be used with latex condoms for safe use.

Condoms should be placed immediately before ejaculation. Condoms should be put on before any genital contact to prevent the risk of pregnancy and sexually transmitted infections (STIs). They should not be placed only before ejaculation.

Diaphragms should be removed 4 hours after intercourse. Diaphragms should be left in place for at least 6 hours but no longer than 24 hours after intercourse to prevent the risk of toxic shock syndrome and ensure effectiveness.

Abdominal pain is a manifestation of complications of oral contraceptive use. While abdominal pain can indicate complications, such as ectopic pregnancy or hepatic issues, it should not be considered a typical side effect.

Intrauterine devices should be replaced every 2 years. While some hormonal IUDs are effective for 3-5 years, copper IUDs can last up to 10-12 years. Patients should be informed about the specific replacement schedule based on the type of IUD used.

Answers that don’t need follow-up:

Diaphragms should be refitted after pregnancy. After a woman has a baby, the size and shape of her vagina and cervix can change, so diaphragms need to be refitted to ensure proper effectiveness.

Herbal supplements can affect the effectiveness of oral contraceptives. Some herbal supplements, such as St. John’s Wort, can interact with hormonal contraceptives, potentially reducing their effectiveness.

Presence of intrauterine device (IUD) strings should be checked after each menstrual cycle. Women should check the IUD strings regularly, typically after each menstrual cycle, to ensure the device is in place and to identify any potential complications.