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 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

The correct answer is choice A.“You need to have a sperm count test to confirm your sterility.”

A sperm count test is a semen analysis that measures the number of sperm in the ejaculate.

It is the only way to verify that a vasectomy has been successful and that the man is sterile.A man is considered sterile when his sperm count is zero or below 100,000 non-motile sperm per sample.

Choice B is wrong because the number of ejaculations does not guarantee sterility.Some sperm may still be present in the severed vas deferens for months after a vasectomy.

Choice C is wrong because the duration of contraception use after a vasectomy depends on the sperm count test results, not on a fixed time period.It may take more or less than 3 months for a man to become sterile after a vasectomy.

Choice D is wrong because a repeat vasectomy is unnecessary and ineffective to ensure sterility.A vasectomy is a permanent birth control method that rarely fails or reverses.