A nurse in the ambulatory surgery center is providing discharge teaching to a client who had a dilation and curettage (D&C) following a spontaneous miscarriage. Which of the following should be included in the teaching?

Choice A: Vaginal intercourse can be resumed after 2 weeks.

Reason: After a dilation and curettage (D&C) procedure, it is generally recommended to avoid vaginal intercourse for about 2 weeks. This allows the cervix and uterus to heal and reduces the risk of infection. Engaging in sexual activity too soon can introduce bacteria into the uterus, which is particularly vulnerable following the procedure.

Choice B: Products of conception will be present in vaginal bleeding.

Reason: This statement is incorrect. After a D&C, the products of conception should have been removed during the procedure. While some bleeding is normal, it should not contain products of conception. Instead, the bleeding should be similar to a menstrual period.

Choice C: Increased intake of zinc-rich foods is recommended.

Reason: There is no specific recommendation for increasing zinc intake following a D&C. The focus is typically on general post-operative care, such as rest, hydration, and monitoring for signs of infection. While a balanced diet is always beneficial, there is no evidence suggesting that zinc-rich foods are particularly necessary after this procedure.

Choice D: Aspirin may be taken for cramps.

Reason: This statement is incorrect. Aspirin is generally not recommended for pain relief after a D&C because it can increase the risk of bleeding. Instead, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are usually recommended for managing cramps and pain.

Choice A: Protrusion of the posterior bladder wall downward through the anterior vaginal wall is not the correct answer because it describes a different condition called cystocele. A cystocele occurs when the bladder pushes into the vagina due to weakened pelvic support structures.

Choice B: Bulging of the small intestine through the posterior vaginal wall is the correct answer because it describes an enterocele. Enterocele occurs when the small intestine slides into a pouch between the rectum and vagina due to weakened pelvic support structures.

Choice C: Descent of the uterus through the pelvic floor into the vagina is not the correct answer because it describes a different condition called uterine prolapse. Uterine prolapse occurs when the uterus drops down into or out of the vagina due to weakened pelvic support structures.

Choice D: Sagging of the rectum with the pressure exerted against the posterior vaginal wall is not the correct answer because it describes a different condition called rectocele. Rectocele occurs when the rectum bulges into or out of the vagina due to weakened pelvic support structures.