A nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive (COC). The nurse recognizes that which of the following client medications can interfere with the effectiveness of the COC?

Choice A rationale

High-absorbency tampons are a known risk factor for toxic shock syndrome (TSS). TSS is a rare, life-threatening complication of certain types of bacterial infections. Often TSS results from toxins produced by Staphylococcus aureus (staph) bacteria, but the condition may also be caused by toxins produced by group A streptococcus (strep) bacteria. The condition is caused due to bacterial toxins from Streptococcus or Staphylococcus infection. Bacteria usually enter the body through openings in the skin such as wounds or cuts. The risk factors include open skin wound, having had recent surgery, using superabsorbent tampons or contraceptive sponges. Therefore, the nurse should include the use of high-absorbency tampons in the teaching as increasing the risk for contracting TSS.

Choice B rationale

Travel to foreign countries is not specifically mentioned as a risk factor for TSS. While traveling can expose individuals to a variety of health risks depending on the destination, it is not directly linked with an increased risk of TSS1234.

Choice C rationale

Mosquito bites are not a known risk factor for TSS. Mosquito bites can transmit certain diseases such as malaria, dengue fever, and Zika virus, but they are not associated with TSS1234.

Choice D rationale

Having multiple sexual partners can increase the risk of sexually transmitted infections, but it is not a known risk factor for TSS. TSS is typically associated with superabsorbent tampon use, skin wounds, and recent surgery.

Choice A rationale

While seeing a counselor could be beneficial for some women experiencing doubts and second thoughts about their pregnancy, it is not necessarily the first or only option. Many women experience a range of emotions during pregnancy, and these feelings are often temporary.

Choice B rationale

Telling a woman not to worry and that she will be fine once the baby is born may minimize her feelings and concerns. It’s important to validate her feelings and provide support.

Choice C rationale

While talking to a trusted family member or friend can be helpful, it’s not the only option. Some women may not feel comfortable discussing their feelings with family members.

Choice D rationale

Ambivalent feelings are quite common for women early in pregnancy. It’s a time of significant change, and it’s normal to have mixed feelings about it. It can be helpful to discuss these feelings with a healthcare provider, who can provide reassurance and resources.