A nurse is performing a contraction stress test (CST) on a client who is at 40 weeks of gestation.The results of the test indicate a negative CST.
Which of the following actions should the nurse take?

Choice A rationale

Irregular spotting is common after the placement of an IUD as the body adjusts to the device. This is a normal side effect and typically resolves within a few months.

Choice B rationale

Avoiding tampons initially after IUD placement is advised to prevent displacement or infection. Once the IUD is properly positioned and the risk of infection decreases, tampons can generally be used.

Choice C rationale

Informed consent is required prior to IUD placement to ensure the client understands the procedure, potential risks, and benefits, ensuring an informed decision.

Choice D rationale

IUDs typically need to be replaced every 3 to 10 years, depending on the type. Replacing an IUD every 2 years is not accurate and does not align with standard medical recommendations.

The client is most likely experiencing an ectopic pregnancy. Here's why:

• Symptoms: The client presents with intermittent vaginal bleeding and dull left lower quadrant abdominal pain, which are common symptoms of an ectopic pregnancy.
• Physical Examination: Tenderness upon palpation in the left lower quadrant and an enlarged uterus consistent with 8 weeks of gestation are also indicative of an ectopic pregnancy.

Actions to Take

1. Perform ultrasound: To confirm the diagnosis and locate the ectopic pregnancy.
2. Administer IV fluids: To stabilize the client and prepare for potential surgical intervention.

Parameters to Monitor

1. Vaginal bleeding: To assess the severity and progression of the bleeding.
2. Blood pressure: To monitor for signs of internal bleeding or hemodynamic instability.