A nurse is caring for a patient who uses a contraceptive vaginal ring.

Which of the following symptoms should the nurse instruct the patient to report immediately?

The correct answer is choice D. Choice D is wrong because it implies that the IUD affects fertility, which is not true.According to the NHS website, “Your fertility will return to normal as soon as the IUD is taken out.” The other choices are correct because:

• Choice A is correct because the copper IUD does not contain any hormones and can be used by people who cannot or do not want to use hormonal methods of contraception.
• Choice B is correct because a pregnancy test is needed before inserting an IUD to make sure that the person is not already pregnant.
• Choice C is correct because the hormonal IUD can reduce menstrual pain and heavy bleeding by thinning the lining of the uterus and thickening the cervical mucus.

Therefore, choice D indicates a need for further teaching.

The correct answer is choice D.“You should wait until your baby is 6 weeks old before starting the injections.” This is because medroxyprogesterone may pass into breast milk and cause side effects in a child who is breastfed.The product labeling states that it should be started no sooner than 6 weeks postpartum, based on data submitted for product approval.

The World Health Organization also recommends that injectable depot medroxyprogesterone acetate should not be used before 6 weeks postpartum.

Choice A is wrong because starting the injections immediately after delivery could interfere with the exclusivity or duration of lactation, and could affect the newborn infant adversely because of slower metabolism of the drug than older infants.

Choice B is wrong because waiting until the baby is 6 months old is unnecessary and could expose the mother to a higher risk of unintended pregnancy.

Choice C is wrong because medroxyprogesterone has not been known to cause any decrease in milk supply while using the injections