A nurse is providing discharge teaching about postpartum contraception for a client who is breastfeeding and wishes to begin using contraceptive immediately. Which of the following methods should the nurse discuss with the client?
Progestin oral contraceptive
Vaginal etonogestrel/ethinyl estradiol contraceptive ring
Transdermal estrogen/progesterone patch
Injectable synthetic progestin
The Correct Answer is A
A. Progestin oral contraceptive: Progestin-only oral contraceptives (often called the “mini-pill”) are safe to use immediately postpartum for breastfeeding clients because they do not affect milk production. They provide effective contraception without the risks associated with estrogen-containing methods.
B. Vaginal etonogestrel/ethinyl estradiol contraceptive ring: Combination estrogen-progestin contraceptives, such as the vaginal ring, are generally not recommended immediately postpartum for breastfeeding clients because estrogen can reduce milk supply and may increase the risk of thromboembolism.
C. Transdermal estrogen/progesterone patch: Similar to other estrogen-containing methods, the transdermal patch is not recommended immediately postpartum for breastfeeding clients due to potential interference with lactation and increased thromboembolism risk.
D. Injectable synthetic progestin: Injectable progestin (e.g., depot medroxyprogesterone acetate) is safe for breastfeeding, but it is not ideal for immediate postpartum use if the client wishes for rapid return to fertility later, since its effects can last for several months. It may also have delayed effects on bone density with long-term use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Clean the insertion site with betadine: While povidone-iodine (Betadine) can be used, current guidelines recommend using chlorhexidine for central line site care because it is more effective in preventing catheter-related bloodstream infections. Using betadine is not the preferred standard of care.
B. Flush the catheter with sterile water: Central venous catheters should be flushed with sterile saline, not sterile water, to maintain patency and avoid hemolysis or electrolyte imbalance. Flushing with water can damage blood cells and the catheter.
C. Use a 5-mL syringe to flush the catheter: A minimum of a 10-mL syringe is recommended when flushing a central venous catheter because smaller syringes generate excessive pressure that can damage the catheter. Using a 5-mL syringe increases the risk of catheter rupture.
D. Wear sterile gloves when providing site care: Sterile technique is required when performing central line site care to prevent infection. Wearing sterile gloves protects the client from pathogens and is a critical step in maintaining asepsis during dressing changes and catheter maintenance.
Correct Answer is A
Explanation
A. Maintain a constant, gentle suction on the drainage device: A portable wound bulb suction device is used to remove blood and serous fluid, prevent hematoma or seroma formation, and promote wound healing. Maintaining constant, gentle suction ensures effective drainage and reduces the risk of complications such as infection or fluid accumulation.
B. Place the client in the supine position while resting in bed: After a mastectomy, clients are typically positioned with the head of the bed elevated and the affected arm supported on a pillow to reduce swelling and promote comfort. Supine positioning without support may increase tension on the surgical site and impair drainage.
C. Prepare to remove the drainage tube 24 hr after the procedure: Drainage tubes are usually removed when output is minimal, often 24–48 hours or longer depending on the volume and type of drainage. Removing the tube at a fixed 24-hour mark may be premature and could increase the risk of fluid accumulation.
D. Notify the provider for drainage of 25 mL in 24 hr: Drainage of 25 mL in 24 hours is minimal and typically does not require provider notification. Normal early postoperative drainage is expected, and the nurse should continue routine monitoring and documentation rather than escalate care for this amount.
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