A nurse is reviewing the mechanism of action of IUDs with a group of nursing students.
Which of the following statements by a student indicates an understanding of the teaching?
“IUDs immobilize sperm and interfere with their migration from the vagina to the fallopian tubes.”.
“IUDs speed up the transport of the ovum through the fallopian tube.”.
“IUDs inhibit fertilization and cause lysis of the blastocyst.”.
All of the above
The Correct Answer is D
All of the above.
This is because IUDs have multiple mechanisms of action that prevent fertilization and implantation of the ovum. According to the search results, some of these mechanisms are:
- IUDs immobilize sperm and interfere with their migration from the vagina to the fallopian tubes. This is because copper ions released from copper IUDs are toxic for spermatozoa and impair their motility and viability. Hormonal IUDs also thicken the cervical mucus, which blocks sperm from entering the uterus.
- IUDs speed up the transport of the ovum through the fallopian tube. This is because IUDs induce a local inflammatory reaction in the endometrium, which affects the signaling between the uterus and the ovary and alters the tubal motility. This reduces the chances of fertilization by shortening the time window for sperm-egg interaction.
- IUDs inhibit fertilization and cause lysis of the blastocyst. This is because IUDs affect the function or viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed. IUDs also interfere with implantation of the fertilized ovum by creating a hostile environment in the uterine cavity.
Choice A is wrong because it only describes one mechanism of action of IUDs, not all of them.
Choice B is wrong because it only describes another mechanism of action of IUDs, not all of them.
Choice C is wrong because it only describes yet another mechanism of action of IUDs, not all of them.
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Correct Answer is B
Explanation
The correct answer is choice B. The client has a positive pregnancy test result.
This is a contraindication for bilateral tubal ligation because the procedure is a permanent form of contraception and should not be performed on a pregnant woman.
The client should be counseled about other options for birth control or termination of pregnancy.
Choice A is wrong because a history of pelvic inflammatory disease is not a contraindication for bilateral tubal ligation.It may increase the risk of complications from the surgery, such as infection or adhesions, but it does not prevent the procedure from being performed.
Choice C is wrong because a family history of breast cancer is not a contraindication for bilateral tubal ligation.It may affect the client’s decision to undergo the procedure, as some studies have suggested that tubal ligation may reduce the risk of ovarian cancer, which is associated with breast cancer.
However, this is not a medical reason to avoid the surgery.
Choice D is wrong because a history of endometriosis is not a contraindication for bilateral tubal ligation.
It may cause pelvic pain or infertility, but it does not affect the effectiveness or safety of the procedure.In fact, some studies have shown that tubal ligation may improve the symptoms of endometriosis by reducing retrograde menstruation.
Correct Answer is B
Explanation
The correct answer is choice B. Increased serum potassium level.Oral contraceptives can affect the levels of various electrolytes in the blood, such as sodium, potassium, calcium and magnesium.According to one study, oral contraceptives can increase the levels of serum copper, iron, calcium and cadmium, and decrease the levels of serum zinc, selenium, phosphorus and magnesium.
Therefore, a high serum potassium level can indicate an adverse effect of oral contraceptives on this client.
Choice A is wrong because oral contraceptives do not decrease serum glucose level.In fact, they can increase the plasma glucose level and insulin response, which can impair glucose tolerance and increase the risk of diabetes.
Choice C is wrong because oral contraceptives do not decrease serum triglyceride level.On the contrary, they can increase the fasting triglyceride level by 13 to 75 percent, which can elevate the risk of cardiovascular disease.
Choice D is wrong because oral contraceptives do not increase serum protein level.They can increase the levels of some apolipoproteins, such as A-I, A-II and B, but these are not the same as total protein.
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