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A nurse is caring for a client who has an intrauterine device (IUD) in place and reports lower abdominal pain and fever for 2 days.

Which of the following actions should the nurse take?

A.

Instruct the client to take ibuprofen for pain relief

B.

Advise the client to avoid sexual intercourse until symptoms resolve

C.

Obtain a urine specimen for culture and sensitivity

D.

Refer the client to a provider for evaluation

Answer and Explanation

The Correct Answer is D

The correct answer is choice D. Refer the client to a provider for evaluation. Lower abdominal pain and fever for 2 days can indicate a serious complication of IUD use, such as pelvic inflammatory disease (PID) or perforation of the uterus.

These conditions require prompt medical attention and possible removal of the IUD.

Choice A is wrong because ibuprofen may not be enough to relieve the pain and may mask the signs of infection.

Choice B is wrong because avoiding sexual intercourse will not treat the underlying cause of the symptoms and may delay seeking medical help.

Choice C is wrong because a urine specimen may not be sufficient to diagnose the problem and may miss other possible causes of lower abdominal pain and fever, such as ectopic pregnancy or appendicitis.


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Related Questions

Correct Answer is B

Explanation

The correct answer is choice B.Spotting and irregular bleeding are potential adverse effects of the copper IUD.The copper IUD works by creating a toxic environment for sperm and eggs in the uterus and cervix, but it does not affect the hormones that regulate the menstrual cycle.Therefore, it can cause changes in bleeding patterns, such as heavier, longer or more painful periods.

Choice A is wrong because decreased bone density is not a side effect of the copper IUD.It is a possible side effect of hormonal IUDs that contain progestin, which can lower estrogen levels and affect bone health.

Choice C is wrong because mood changes are not a side effect of the copper IUD.They are more likely to occur with hormonal methods of birth control that affect the levels of estrogen and progesterone in the body.

Choice D is wrong because headaches are not a side effect of the copper IUD.They are also more common with hormonal methods of birth control, especially those that contain estrogen.

Correct Answer is C

Explanation

The correct answer is choice C. Copper intrauterine device.This is because copper intrauterine devices do not contain hormones and are therefore safe for women with a history of breast cancer and cardiovascular disease.

Some possible explanations for the other choices are:

  • Choice A. Injectable progestins.This is wrong because injectable progestins may increase the risk of breast cancer in women with the BRCA1 geneand may also worsen hypertension and dyslipidemia.
  • Choice B. Contraceptive vaginal ring.This is wrong because contraceptive vaginal rings contain estrogen and progestin, which may increase the risk of thromboembolic events, stroke, and myocardial infarction in women with cardiovascular disease.
  • Choice D. Combined oral contraceptives.This is wrong because combined oral contraceptives also contain estrogen and progestin, which have the same risks as contraceptive vaginal rings for women with cardiovascular disease.Additionally, combined oral contraceptives may interact with some medications used to treat chronic conditions and reduce their effectiveness.

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