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A nurse is caring for a client who has an IUD and reports abdominal pain during sexual intercourse.

Which of the following actions should the nurse take first?

A.

Assess for signs of pelvic inflammatory disease

B.

Instruct the client to check the string length

C.

Advise the client to use a backup contraceptive method

D.

Schedule an appointment for IUD removal

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. The nurse should assess for signs of pelvic inflammatory disease (PID), which is an infection of the female reproductive organs that can be caused by sexually transmitted bacteria. PID can cause abdominal pain during sexual intercourse, as well as other symptoms such as fever, unusual vaginal discharge, and bleeding between periods. PID can lead to serious complications such as infertility and ectopic pregnancy if left untreated.

Choice B is wrong because checking the string length of the IUD is not a priority action. The string length may change due to normal variations in the position of the uterus and cervix, and does not indicate a problem with the IUD. However, if the string is missing or longer than usual, it may suggest that the IUD has moved or expelled, and the client should see a provider.

Choice C is wrong because advising the client to use a backup contraceptive method is not a priority action. The IUD is a highly effective form of birth control that does not require additional methods unless the client wants to prevent STIs. However, if the client has an STI that causes PID, using a condom may help prevent further infection and transmission.

Choice D is wrong because scheduling an appointment for IUD removal is not a priority action. The IUD does not cause PID, but it may increase the risk of infection shortly after insertion, especially if the client has an STI. The risk of PID from IUD use is very low (less than 1%) and usually disappears after 3 weeks of placement. Removing the IUD may not cure PID and may expose the client to unwanted pregnancy.


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Related Questions

Correct Answer is D

Explanation

The nurse should include all of the following information in the teaching:

  • The typical failure rate for IUDs is 1% to 3% per year.
  • This means that out of 100 women who use an IUD for a year, one to three may get pregnant.
  • The risk of pelvic inflammatory disease (PID) is highest in the first 6 weeks after insertion.
  • PID is an infection of the reproductive organs that can cause infertility, chronic pain, or ectopic pregnancy.
  • The risk of PID is higher if the woman or her partner has multiple sexual partners or a sexually transmitted infection (STI).
  • The IUD can be inserted at any time during the menstrual cycle.
  • However, some doctors may prefer to insert it during or right after the period, when the cervix is more open and the chance of pregnancy is lower.

Choice A is wrong because it only states one piece of information that the nurse should include in the teaching.

Choice B is wrong because it only states one piece of information that the nurse should include in the teaching.

Choice C is wrong because it only statesone piece of information that the nurse should include in the teaching

Correct Answer is A

Explanation

The correct answer is choice A.“You need to have a sperm count test to confirm your sterility.”

A sperm count test is a semen analysis that measures the number of sperm in the ejaculate.

It is the only way to verify that a vasectomy has been successful and that the man is sterile.A man is considered sterile when his sperm count is zero or below 100,000 non-motile sperm per sample.

Choice B is wrong because the number of ejaculations does not guarantee sterility.Some sperm may still be present in the severed vas deferens for months after a vasectomy.

Choice C is wrong because the duration of contraception use after a vasectomy depends on the sperm count test results, not on a fixed time period.It may take more or less than 3 months for a man to become sterile after a vasectomy.

Choice D is wrong because a repeat vasectomy is unnecessary and ineffective to ensure sterility.A vasectomy is a permanent birth control method that rarely fails or reverses.

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