During the postpartum period, a client with heart disease and type 2 diabetes asks the nurse, "Which contraceptive will I be able to use to prevent pregnancy in the near future?". What is the best response by the nurse?
You have little to worry about regarding becoming pregnant in the near future, because of your illness.
You should use foam with a condom to prevent pregnancy; this is the safest method.
You may use oral hormonal contraceptives; they are very effective in preventing pregnancy.
The intrauterine device may be a good choice because of its high effectiveness and ease of use.
The Correct Answer is D
Choice A rationale
While certain maternal health conditions, such as severe heart disease, can affect the timing of the return to ovulation, conception is still possible and occurs frequently in the postpartum period. Ovulation typically returns about 4 to 6 weeks after birth in non-lactating women, necessitating the use of effective contraception for all sexually active women who wish to avoid pregnancy, especially those with high-risk conditions.
Choice B rationale
Barrier methods like foam with a condom are less effective than many other forms of contraception, with a typical use failure rate of about 13-21.
Choice C rationale
Combined oral hormonal contraceptives (COCs), which contain both estrogen and progestin, are generally contraindicated in women with certain types of heart disease (e.g., ischemic heart disease, heart failure) and diabetes with vascular complications, due to the increased risk of thromboembolism and cardiovascular events associated with estrogen exposure.
Choice D rationale
The intrauterine device (IUD) is an excellent choice for a postpartum client with heart disease and type 2 diabetes because it is a long-acting reversible contraceptive (LARC), which is one of the most effective methods (typical failure rate <1%) and its effects are local or progestin-only (if hormonal), which avoids the systemic risks associated with estrogen-containing contraceptives.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["8"]
Explanation
Step 1 is: Calculate the total amount of oxytocin in milliunits (mU):. 30 units × (1,000 mU/1 unit) = 30,000 mU.
Step 2 is: Calculate the concentration of oxytocin in mU/mL:. 30,000 mU ÷ 500 mL = 60 mU/mL.
Step 3 is: Calculate the total amount of oxytocin administered per hour (mU/hr):. 60 mU/mL × 8 mL/hr = 480 mU/hr.
Step 4 is: Convert the infusion rate from mU/hr to mU/min:. 480 mU/hr ÷ 60 min/hr = 8 mU/min. Final calculated answer: 8mU/min
Correct Answer is C
Explanation
Choice A rationale
Knowing when contractions began is important for assessing the progression and duration of labor and determining the phase of labor the client is in. However, when birth is imminent, this information is secondary to assessing the integrity of the amniotic sac. Immediate risk assessment for the baby is the top priority for imminent delivery.
Choice B rationale
The estimated due date (EDD) is vital for determining fetal maturity and potential risks associated with prematurity or post-term gestation. While essential data, the EDD does not address the immediate safety and delivery logistics when birth is imminent. The most urgent question relates to current membrane status and imminent delivery risk.
Choice C rationale
Ascertaining if the membranes have ruptured is the most crucial question when delivery is imminent because it directly relates to immediate fetal risk and delivery preparation. Ruptured membranes with a presenting part not engaged increases the risk of umbilical cord prolapse, a true obstetric emergency, and also requires urgent sterile assessment and documentation of the fluid's color and time of rupture.
Choice D rationale
Parity (whether this is the first pregnancy) is significant as multiparas (those with previous pregnancies) often have faster labors and deliveries due to a more compliant cervix and uterus. While informative for estimating delivery speed, it is less critical than establishing the immediate status of the amniotic fluid and cord to ensure a safe, planned delivery.
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