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A nurse is preparing to insert an IUD for a client who is nulliparous and has a negative pregnancy test.

Which of the following actions should the nurse take before the insertion?

A.

Obtain informed consent from the client

B.

Perform a Pap smear and cervical culture

C.

Administer an analgesic medication

D.

All of the above

Answer and Explanation

The Correct Answer is D

The correct answer is choice D.

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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Related Questions

Correct Answer is A

Explanation

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.

Correct Answer is D

Explanation

All of the above.

This is because IUDs have multiple mechanisms of action that prevent fertilization and implantation of the ovum.According to the search results, some of these mechanisms are:

  • IUDs immobilize sperm and interfere with their migration from the vagina to the fallopian tubes.This is because copper ions released from copper IUDs are toxic for spermatozoa and impair their motility and viability.Hormonal IUDs also thicken the cervical mucus, which blocks sperm from entering the uterus.
  • IUDs speed up the transport of the ovum through the fallopian tube.This is because IUDs induce a local inflammatory reaction in the endometrium, which affects the signaling between the uterus and the ovary and alters the tubal motility.This reduces the chances of fertilization by shortening the time window for sperm-egg interaction.
  • IUDs inhibit fertilization and cause lysis of the blastocyst.This is because IUDs affect the function or viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed.IUDs also interfere with implantation of the fertilized ovum by creating a hostile environment in the uterine cavity.

Choice A is wrong because it only describes one mechanism of action of IUDs, not all of them.

Choice B is wrong because it only describes another mechanism of action of IUDs, not all of them.

Choice C is wrong because it only describes yet another mechanism of action of IUDs, not all of them.

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