A nurse is reviewing the laboratory results of a client who is taking medroxyprogesterone injections for contraception.

Which of the following findings should the nurse report to the provider?

The correct answer is choice A.History of migraine headaches with aura is a contraindication for using COCs because it increases the risk of stroke.

Some possible explanations for the other choices are:

• Choice B is wrong because history of dysmenorrhea and menorrhagia is not a contraindication for using COCs.In fact, COCs may help reduce menstrual pain and bleeding.
• Choice C is wrong because history of acne vulgaris and hirsutism is not a contraindication for using COCs.In fact, COCs may help improve acne and hirsutism by reducing androgen levels.
• Choice D is wrong because history of iron-deficiency anemia and fatigue is not a contraindication for using COCs.In fact, COCs may help prevent iron-deficiency anemia by reducing menstrual blood loss.

Normal ranges for relevant parameters are:

• Blood pressure: <140/90 mmHg
• Body mass index: 18.5–24.9 kg/m
• Hemoglobin: 12–16 g/dL for women

The correct answer is choice B.Spotting and irregular bleeding are potential adverse effects of the copper IUD.The copper IUD works by creating a toxic environment for sperm and eggs in the uterus and cervix, but it does not affect the hormones that regulate the menstrual cycle.Therefore, it can cause changes in bleeding patterns, such as heavier, longer or more painful periods.

Choice A is wrong because decreased bone density is not a side effect of the copper IUD.It is a possible side effect of hormonal IUDs that contain progestin, which can lower estrogen levels and affect bone health.

Choice C is wrong because mood changes are not a side effect of the copper IUD.They are more likely to occur with hormonal methods of birth control that affect the levels of estrogen and progesterone in the body.

Choice D is wrong because headaches are not a side effect of the copper IUD.They are also more common with hormonal methods of birth control, especially those that contain estrogen.