A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?

This is because migraine headaches with aura are a contraindication for receiving oral contraceptives, as they increase the risk of stroke and other cardiovascular complications.

Some possible explanations for the other choices are:

Choice B: A 32-year-old client who has endometriosis.

This is not a contraindication for receiving oral contraceptives, as they can actually help reduce the symptoms of endometriosis by suppressing ovulation and reducing menstrual bleeding.

Choice C: A 28-year-old client who has polycystic ovary syndrome (PCOS).

This is not a contraindication for receiving oral contraceptives, as they can help regulate the menstrual cycle and lower the levels of androgens (male hormones) that cause acne, hirsutism (excess hair growth), and other problems in women with PCOS.

Choice D: A 22-year-old client who has irregular menstrual cycles.

This is not a contraindication for receiving oral contraceptives, as they can help normalize the menstrual cycle and prevent unintended pregnancy.

Normal ranges for oral contraceptive doses are:

Estrogen: 10 to 35 mcg of ethinyl estradiol or estradiol valerate

Progestin: varies depending on the type and brand of oral contraceptive

The patient should wear loose-fitting clothing and lie supine on an examination table.

This is because loose-fitting clothing allows easy access to the abdomen and lying supine helps relax the abdominal muscles.

The patient should also avoid food and drinks for 8 to 12 hours before the test, as undigested food can interfere with the sound waves and affect the image quality.

Choice A is wrong because a full bladder is not necessary for an abdominal ultrasound, unless the patient is pregnant or has a pelvic condition.

A transvaginal ultrasound is a different type of ultrasound that uses a probe inserted into the vagina to examine the reproductive organs.

Choice B is wrong because tight-fitting clothing can restrict the movement of the ultrasound probe and make it harder to get a clear image.

Lying prone (on the stomach) can also tense up the abdominal muscles and obscure the organs.

Choice D is wrong because lying prone can have the same disadvantages as choice B. Additionally, wearing loose-fitting clothing does not mean that the patient can eat or drink anything before the test, as this can affect the results.