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 choiceD.

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.

The correct answer is choice B.The patient should receive the injection withinsevendays after delivery if breastfeeding, not five.Injectable progestins are a type of hormonal contraception that prevent ovulation and thicken cervical mucus.They are given by a health professional every 12 weeks.

Choice A is wrong because injectable progestins may cause bone mineral loss with long-term use, so the patient should be aware of this risk.

Choice C is wrong because injectable progestins may cause decreased bleeding or amenorrhea in some women, which is not harmful but may be unexpected.

Choice D is wrong because injectable progestins are given every three months, not four times per year.