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

The statement “I will use only nonprescription medications while pregnant” indicates a need for further teaching. Not all nonprescription (over-the-counter) medications are safe to use during pregnancy. Some may have effects on the fetus and others may affect the course of the pregnancy.

Choice B rationale

It’s important for pregnant women to discuss any home remedies for nausea or other symptoms with their doctor, as some remedies may not be safe during pregnancy.

Choice C rationale

Monitoring weight gain during pregnancy is important as excessive or insufficient weight gain can lead to complications such as gestational diabetes, hypertension, or growth issues for the baby.

Choice D rationale

Reducing stress levels during pregnancy is beneficial for both the mother and the baby’s health. High levels of stress can lead to complications such as preterm labor and low birth weight.

Choice A rationale

Hypertension is the most common risk factor for placental abruption. Placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery. This can decrease or block the baby’s supply of oxygen and nutrients and cause heavy bleeding in the mother. Chronic high blood pressure (hypertension) is a known risk factor for placental abruption.

Choice B rationale

While blunt force trauma can be a cause of placental abruption, it is not the most common risk factor. Trauma or injury to the abdomen can cause placental abruption, but hypertension is a more common risk factor.

Choice C rationale

Cigarette smoking is a known risk factor for placental abruption, but it is not the most common risk factor. Smoking during pregnancy can increase the risk of placental abruption, but hypertension is a more common risk factor.

Choice D rationale

Cocaine use is a known risk factor for placental abruption, but it is not the most common risk factor. Use of cocaine during pregnancy can increase the risk of placental abruption, but hypertension is a more common risk factor.