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

Moderate exercise improves circulation. This statement is accurate and should be included in the teaching. Regular moderate exercise during pregnancy can have many benefits, including improved circulation, which can help reduce swelling and varicose veins. It can also help manage weight gain, improve mood and energy levels, reduce pregnancy discomfort, prepare the body for labor, and boost stamina for labor and delivery.

Choice B rationale

Refrain from exercises that include stretching. This statement is not accurate and should not be included in the teaching. Stretching exercises can be beneficial during pregnancy. They can help improve flexibility, reduce muscle tension, alleviate pregnancy discomfort, and prevent muscle imbalances. However, pregnant women should be careful not to stretch too far, as the hormones produced during pregnancy can make the ligaments more flexible and easier to stretch, increasing the risk of injuries.

Choice C rationale

It is recommended to rest for 30 minutes before each new exercise. This statement is not accurate and should not be included in the teaching. While it’s important for pregnant women to rest and avoid overexertion, there’s no specific recommendation to rest for 30 minutes before each new exercise. Instead, pregnant women should listen to their bodies and rest as needed.

Choice D rationale

It is recommended to increase your weight-bearing exercises. This statement is not accurate and should not be included in the teaching. While weight-bearing exercises can be beneficial, they should be done with caution during pregnancy. Pregnant women should avoid heavy weights and exercises that put pressure on the joints, increase the risk of injury, or cause discomfort. Instead, they should focus on exercises that strengthen the muscles and improve balance and flexibility.