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A nurse is counseling a client who is breastfeeding and wants to use medroxyprogesterone injections for contraception.

Which of the following statements should the nurse make?

A.

"You can start the injections immediately after delivery.".

B.

"You should wait until your baby is 6 months old before starting the injections.".

C.

"You may notice a decrease in your milk supply while using the injections.".

D.

"You should wait until your baby is 6 weeks old before starting the injections.".

Answer and Explanation

The Correct Answer is D

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


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Related Questions

Correct Answer is C

Explanation

The correct answer is choice C. Copper intrauterine device.This is because copper intrauterine devices do not contain hormones and are therefore safe for women with a history of breast cancer and cardiovascular disease.

Some possible explanations for the other choices are:

  • Choice A. Injectable progestins.This is wrong because injectable progestins may increase the risk of breast cancer in women with the BRCA1 geneand may also worsen hypertension and dyslipidemia.
  • Choice B. Contraceptive vaginal ring.This is wrong because contraceptive vaginal rings contain estrogen and progestin, which may increase the risk of thromboembolic events, stroke, and myocardial infarction in women with cardiovascular disease.
  • Choice D. Combined oral contraceptives.This is wrong because combined oral contraceptives also contain estrogen and progestin, which have the same risks as contraceptive vaginal rings for women with cardiovascular disease.Additionally, combined oral contraceptives may interact with some medications used to treat chronic conditions and reduce their effectiveness.

Correct Answer is D

Explanation

The correct answer is choiceD.

All of the above.

Here is why:

  • Choice A is correct because obtaining informed consent from the client is a necessary step before any invasive procedure, including IUD insertion.
  • Choice B is correct because performing a Pap smear and cervical culture can help screen for cervical cancer and sexually transmitted infections, which are contraindications for IUD use.
  • Choice C is correct because administering an analgesic medication can help reduce the pain and discomfort associated with IUD insertion, especially in nulliparous women who have a smaller cervical diameter.
  • Choice D is correct because it includes all of the above actions, which are recommended by the American College of Obstetricians and Gynecologists (ACOG) for IUD insertion in nulliparous women.
  • Choice A is wrong if it is the only action taken, because it does not address the other aspects of IUD insertion such as screening and pain management.
  • Choice B is wrong if it is the only action taken, because it does not ensure the client’s consent and comfort during the procedure.
  • Choice C is wrong if it is the only action taken, because it does not verify the client’s eligibility and suitability for IUD use.

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