A client who had her first baby three months ago and is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client?

After ceasing breastfeeding the diaphragm should be resized.

Use an alternate form of contraception until a new diaphragm is obtained.

If no more than 20 pounds was gained during pregnancy, the diaphragm is safe to use.

Avoid intercourse during ovulation until the size of the diaphragm has been evaluated

Answer and Explanation

The Correct Answer is B

A. After ceasing breastfeeding, the diaphragm should be resized: Breastfeeding can affect vaginal lubrication and elasticity. It might be advisable to have the diaphragm refitted after childbirth and after breastfeeding stops. However, this choice doesn't directly address the current situation.

B. Use an alternate form of contraception until a new diaphragm is obtained: This is a reasonable suggestion. Using a diaphragm that was fitted before pregnancy might not offer adequate protection due to potential changes in the cervix's size or shape after childbirth.

C. If no more than 20 pounds were gained during pregnancy, the diaphragm is safe to use: Weight gain during pregnancy can affect the size and shape of the vagina and cervix. However, specifying a particular weight gain as a safety criterion for using the diaphragm isn't entirely accurate.

D. Avoid intercourse during ovulation until the size of the diaphragm has been evaluated: This is a cautious approach. Waiting until the diaphragm size is confirmed by a healthcare professional could be prudent to ensure the correct fit and effectiveness.

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Correct Answer is A

Explanation

A. Obtain a drug screen for cocaine: Given the symptoms described (tremulous, tachycardic, hypertensive), there may be concern about drug exposure, and cocaine is a substance known to cause such symptoms in newborns. Therefore, obtaining a drug screen for cocaine is a reasonable and important action to determine if there was prenatal exposure.

B. Weigh and measure the newborn: While weighing and measuring the newborn is a routine part of the newborn assessment, it may not be the most crucial action in this context. The symptoms described suggest the need for a more immediate assessment related to possible drug exposure.

C. Determine reactivity of neonatal reflexes: Assessing the reactivity of neonatal reflexes is an important part of the newborn assessment, but in this specific situation, the symptoms described (tremulous, tachycardic, hypertensive) may warrant a more focused and immediate assessment related to drug exposure.

D. Perform gestational age assessment: Gestational age assessment is essential for understanding the newborn's maturity and adjusting care accordingly. However, in this scenario, the immediate concern seems to be the symptoms the newborn is presenting with, and addressing the possibility of drug exposure takes precedence.

A. Obtain blood and urine for prenatal screens B. Explain common complications of pregnancy C. Obtain baseline blood pressure and weight D. Schedule prenatal visits to occur monthly

Correct Answer is A

Explanation

A. Obtain blood and urine for prenatal screens.
This choice is important because it allows the nurse to assess the client's overall health, screen for infections, and identify any potential risks or complications that may impact the pregnancy.

B. Explain common complications of pregnancy.
While educating the client about common complications is valuable, it may not address the immediate need to screen for specific infections or assess the client's current health status. This information can be covered during prenatal education sessions.

C. Obtain baseline blood pressure and weight.
This is a routine part of prenatal care and is important for monitoring the client's health throughout pregnancy. However, if the client has a history of syphilis, obtaining specific prenatal screens (including for syphilis) would be a more targeted and immediate action.

D. Schedule prenatal visits to occur monthly.
Scheduling regular prenatal visits is essential for monitoring the progression of the pregnancy. However, addressing the specific health concerns and obtaining necessary screens take precedence during the initial visit, especially considering the client's history of syphilis.

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A client who had her first baby three months ago and is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client?

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