A nurse is providing client teaching regarding an intrauterine device (IUD). Which of the following statements should the nurse include in the teaching?
You might have to have cultures for sexually transmitted infections prior to placement of the device.
The device will have to be replaced every 2 years.
You might experience irregular spotting the first few months after placement of the device.
You will need to avoid using tampons during menstrual cycles.
You will need to sign informed consent prior to the procedure.
Correct Answer : A,C,E
Choice A rationale
Prior to IUD insertion, screening for sexually transmitted infections (STIs) is crucial to prevent the introduction of pathogens into the upper reproductive tract. An untreated STI, particularly chlamydia or gonorrhea, can lead to pelvic inflammatory disease (PID) when an IUD is placed, as the device might facilitate the ascent of bacteria.
Choice B rationale
The duration of effectiveness for intrauterine devices varies depending on the type. Hormonal IUDs typically last for 3 to 8 years, while copper IUDs can remain effective for up to 10 years. Therefore, the statement that the device must be replaced every 2 years is incorrect and misleading for most available IUDs.
Choice C rationale
Irregular spotting and changes in menstrual bleeding patterns are common side effects during the initial months following IUD placement, particularly with hormonal IUDs. This is due to the local endometrial effects of progesterone release or the inflammatory reaction induced by copper, as the uterus adapts to the foreign body.
Choice D rationale
There is no medical contraindication to using tampons with an IUD. The IUD resides in the uterus, while tampons are inserted into the vaginal canal. There is no physical interaction or risk of dislodgement of the IUD by tampon use. Clients can continue their preferred menstrual hygiene products.
Choice E rationale
Informed consent is a fundamental ethical and legal requirement before any medical procedure, including IUD insertion. The client must be provided with comprehensive information regarding the procedure, including its benefits, risks, alternatives, and potential side effects, to make an autonomous and voluntary decision.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A positive phenylketonuria (PKU) test indicates an inability to metabolize the amino acid phenylalanine, not galactose. Galactosemia is a separate metabolic disorder characterized by the body's inability to break down galactose, a sugar found in milk. Both are inborn errors of metabolism, but their biochemical pathways and dietary interventions differ significantly.
Choice B rationale
A positive PKU test does not indicate a slow metabolism in general. Instead, it specifically points to a deficiency in the enzyme phenylalanine hydroxylase (PAH), which is necessary for converting phenylalanine into tyrosine. This enzymatic defect leads to an accumulation of phenylalanine in the blood and tissues, which can become neurotoxic if untreated.
Choice C rationale
A positive finding for phenylketonuria (PKU) signifies a genetic disorder where the body lacks or has insufficient amounts of the enzyme phenylalanine hydroxylase. This enzyme is crucial for metabolizing the essential amino acid phenylalanine into tyrosine. Without proper enzyme function, phenylalanine accumulates in the blood, leading to neurotoxic effects if a specialized diet is not initiated promptly.
Choice D rationale
A positive PKU finding, if left untreated, directly leads to severe intellectual disability and other neurological problems due to the accumulation of phenylalanine, which is toxic to the developing brain. Therefore, it indicates an increased risk for neurologic anomalies if the condition is not managed through a strict low-phenylalanine diet from early infancy. .
Correct Answer is A
Explanation
Choice A rationale
Following an amniotomy, there is a direct communication between the uterine cavity and the vaginal canal, increasing the risk of ascending infection. Frequent monitoring of the client's temperature, typically every 2 hours, is essential to detect early signs of chorioamnionitis, a bacterial infection of the amniotic sac, which can lead to maternal and fetal complications.
Choice B rationale
Misoprostol is a prostaglandin E1 analog used for cervical ripening and induction of labor, not for post-amniotomy care. Its administration after amniotomy would not be appropriate for managing the immediate risks or discomfort associated with the procedure and could potentially cause excessive uterine contractions.
Choice C rationale
A biophysical profile (BPP) is an antenatal assessment of fetal well-being, typically performed to evaluate fetal oxygenation and central nervous system function. It is not an intervention performed during or immediately after an amniotomy, which is a procedure to rupture the amniotic membranes.
Choice D rationale
Effleurage is a light, rhythmic stroking of the abdomen used as a comfort measure during labor, often to distract from contractions. While it can be a helpful pain management technique, it is not a direct action specifically indicated for addressing the physiological consequences or risks associated with an amniotomy.
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