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?
Instruct the client to take ibuprofen for pain relief
Advise the client to avoid sexual intercourse until symptoms resolve
Obtain a urine specimen for culture and sensitivity
Refer the client to a provider for evaluation
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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Correct Answer is D
Explanation
All of the above.
This is because IUDs have multiple mechanisms of action that prevent fertilization and implantation of the ovum.According to the search results, some of these mechanisms are:
- IUDs immobilize sperm and interfere with their migration from the vagina to the fallopian tubes.This is because copper ions released from copper IUDs are toxic for spermatozoa and impair their motility and viability.Hormonal IUDs also thicken the cervical mucus, which blocks sperm from entering the uterus.
- IUDs speed up the transport of the ovum through the fallopian tube.This is because IUDs induce a local inflammatory reaction in the endometrium, which affects the signaling between the uterus and the ovary and alters the tubal motility.This reduces the chances of fertilization by shortening the time window for sperm-egg interaction.
- IUDs inhibit fertilization and cause lysis of the blastocyst.This is because IUDs affect the function or viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed.IUDs also interfere with implantation of the fertilized ovum by creating a hostile environment in the uterine cavity.
Choice A is wrong because it only describes one mechanism of action of IUDs, not all of them.
Choice B is wrong because it only describes another mechanism of action of IUDs, not all of them.
Choice C is wrong because it only describes yet another mechanism of action of IUDs, not all of them.
Correct Answer is B
Explanation
The correct answer is choice B. Increased serum potassium level.Oral contraceptives can affect the levels of various electrolytes in the blood, such as sodium, potassium, calcium and magnesium.According to one study, oral contraceptives can increase the levels of serum copper, iron, calcium and cadmium, and decrease the levels of serum zinc, selenium, phosphorus and magnesium.
Therefore, a high serum potassium level can indicate an adverse effect of oral contraceptives on this client.
Choice A is wrong because oral contraceptives do not decrease serum glucose level.In fact, they can increase the plasma glucose level and insulin response, which can impair glucose tolerance and increase the risk of diabetes.
Choice C is wrong because oral contraceptives do not decrease serum triglyceride level.On the contrary, they can increase the fasting triglyceride level by 13 to 75 percent, which can elevate the risk of cardiovascular disease.
Choice D is wrong because oral contraceptives do not increase serum protein level.They can increase the levels of some apolipoproteins, such as A-I, A-II and B, but these are not the same as total protein.
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