A nurse is providing discharge instructions to a client who has just received her first medroxyprogesterone injection for contraception.

Which of the following information should the nurse include in the teaching?

The correct answer is choice B. The client has a positive pregnancy test result.

This is a contraindication for bilateral tubal ligation because the procedure is a permanent form of contraception and should not be performed on a pregnant woman.

The client should be counseled about other options for birth control or termination of pregnancy.

Choice A is wrong because a history of pelvic inflammatory disease is not a contraindication for bilateral tubal ligation.It may increase the risk of complications from the surgery, such as infection or adhesions, but it does not prevent the procedure from being performed.

Choice C is wrong because a family history of breast cancer is not a contraindication for bilateral tubal ligation.It may affect the client’s decision to undergo the procedure, as some studies have suggested that tubal ligation may reduce the risk of ovarian cancer, which is associated with breast cancer.

However, this is not a medical reason to avoid the surgery.

Choice D is wrong because a history of endometriosis is not a contraindication for bilateral tubal ligation.

It may cause pelvic pain or infertility, but it does not affect the effectiveness or safety of the procedure.In fact, some studies have shown that tubal ligation may improve the symptoms of endometriosis by reducing retrograde menstruation.

The correct answer is choice C.Foul-smelling vaginal discharge is a sign of a possible infection, which can be a complication of using a copper IUD.

The nurse should instruct the client to report this symptom and seek medical attention.

Choice A is wrong because increased menstrual pain and bleeding are common side effects of copper IUDs, especially in the first 3-6 months after insertion.

They are not necessarily signs of a complication.

Choice B is wrong because irregular spotting or bleeding are also common side effects of copper IUDs.

They are not necessarily signs of a complication.

Choice D is wrong because a change in string length is not a sign of a complication.

The string length may vary depending on the position of the cervix and uterus.The client should check the string length regularly and report any missing or protruding strings, which could indicate displacement of the IUD.