A nurse in an obstetric clinic is caring for four clients. The nurse should identify that an intrauterine device is contraindicated for which of the following clients?
A client who smokes one pack of cigarettes per day
A client who has a history of gallbladder disease
A client who has a positive pregnancy test
A client who is nulliparous
The Correct Answer is C
(A) A client who smokes one pack of cigarettes per day:
While smoking is a significant risk factor for many health issues, including cardiovascular disease, it is not a direct contraindication for the use of an intrauterine device (IUD). However, smokers should be counseled about the risks of smoking and offered support to quit.
(B) A client who has a history of gallbladder disease:
A history of gallbladder disease does not contraindicate the use of an IUD. IUDs are primarily contraindicated in cases of active pelvic infection, certain uterine abnormalities, and confirmed pregnancy, but not gallbladder disease.
(C) A client who has a positive pregnancy test:
An IUD should not be inserted in a client who has a positive pregnancy test. Inserting an IUD during pregnancy can lead to complications such as infection, miscarriage, and preterm birth. It is crucial to confirm the absence of pregnancy before IUD insertion.
(D) A client who is nulliparous:
Being nulliparous (having never given birth) is not a contraindication for IUD use. IUDs can be safely used by nulliparous women, though some might have a slightly higher risk of expulsion or insertion-related discomfort compared to women who have given birth.
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Related Questions
Correct Answer is C
Explanation
(A) "A Papanicolaou test will be performed to detect the presence of herpes simplex type 1."
The Papanicolaou (Pap) test is not performed during pregnancy to detect herpes simplex type 1. The Pap test is a cervical cancer screening test that detects abnormal cervical cells, usually caused by human papillomavirus (HPV) infection or other factors. It is not used to detect herpes simplex type 1.
(B) "A group B streptococcus screening will be performed to determine the presence of STs."
Group B Streptococcus (GBS) screening is performed during pregnancy to detect the presence of GBS bacteria in the mother's genital and rectal areas. GBS is a common bacteria that can cause serious infections in newborns if passed from the mother during childbirth. GBS screening is not related to sexually transmitted infections (STIs).
(C) "A multiple marker screening will be performed to identify neural tube defects."
Multiple marker screening, also known as maternal serum screening or quad screen, is a routine prenatal test performed between 15 and 20 weeks of gestation. It helps identify the risk of certain chromosomal abnormalities, including neural tube defects like spina bifida and anencephaly. This screening measures the levels of certain proteins in the mother's blood to assess the risk of these birth defects.
(D) "A glucose tolerance test will be performed to predict hyperglycemia in your baby."
A glucose tolerance test (GTT) is performed during pregnancy to diagnose gestational diabetes mellitus (GDM), a condition characterized by high blood sugar levels during pregnancy. The purpose of the GTT is to identify maternal hyperglycemia, which can lead to complications for both the mother and the baby. The test is not performed to predict hyperglycemia specifically in the baby.
Correct Answer is D
Explanation
(A) "I will nurse my baby for 5 to 10 minutes on each breast.":
While nursing for 5 to 10 minutes on each breast might work for some babies, it's generally recommended to allow the baby to nurse as long as they are actively sucking and swallowing. The length of time can vary depending on the baby's needs and the mother's milk supply.
(B) "I will make sure that just the nipple is in my baby's mouth.":
This is incorrect because proper latch-on involves the baby having not just the nipple but also a large portion of the areola in their mouth. This ensures effective milk transfer and helps prevent nipple soreness and damage.
(C) "I will apply vitamin E oil to my nipples after each feeding.":
Applying vitamin E oil or any other substance to the nipples is not typically recommended without the advice of a healthcare provider. Some substances can cause irritation or allergic reactions. Instead, if there is nipple soreness, lanolin or expressed breast milk can be used, but it's best to follow guidelines given by a healthcare provider.
(D) "I will lay my baby on a pillow at the level of my breast.":
Using a pillow to support the baby at the level of the breast can help ensure proper positioning and latch during breastfeeding. This position can make breastfeeding more comfortable for both the mother and the baby, promoting effective feeding and reducing the risk of nipple pain.
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