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?
Assess for signs of pelvic inflammatory disease
Instruct the client to check the string length
Advise the client to use a backup contraceptive method
Schedule an appointment for IUD removal
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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.A history of toxic shock syndrome (TSS) is a contraindication for the use of a diaphragm.
TSS is a rare but serious condition caused by a bacterial infection that can occur when using a diaphragm for too long or not cleaning it properly.
Choice B is wrong because a history of uterine fibroids is not a contraindication for the use of a diaphragm.
Uterine fibroids are benign tumors that grow in the uterus and usually do not affect the cervix or the fit of the diaphragm.
Choice C is wrong because a history of irregular menstrual periods is not a contraindication for the use of a diaphragm.
Irregular periods may be caused by various factors such as stress, hormonal imbalance, or medical conditions, but they do not affect the effectiveness or safety of the diaphragm.
Choice D is wrong because a history of breast cancer is not a contraindication for the use of a diaphragm.
Breast cancer is not related to the use of barrier methods of contraception such as the diaphragm.
However, some hormonal methods of contraception may increase the risk of breast cancer or be contraindicated for women who have or had breast cancer.
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