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 C) “No, you should avoid activities that could cause straining or trauma until healing occurs.” This is because a vasectomy is a surgical procedure that involves cutting and sealing the tubes that carry sperm from the testicles to the semen.It requires some time for recovery and healing, and strenuous activities like hunting could increase the risk of bleeding, infection, or reopening the incisions.

Choice A) “Yes, this activity level will be fine.” is wrong because it contradicts the medical advice to rest and avoid heavy lifting or exercise for at least a week after a vasectomy.

Choice B) “No, you should avoid sexual intercourse until your follow-up visit.” is wrong because it is too restrictive.Sexual intercourse can be resumed after a few days or when the pain and swelling subside, as long as contraception is used until the semen is confirmed to be sperm-free.

Choice D) “Yes, but you should wear tight-fitting underwear.” is wrong because it is not enough to prevent complications.Tight-fitting underwear can help support the scrotum and reduce discomfort, but it does not eliminate the need to avoid activities that could cause straining or trauma.

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.