A nurse is providing education to a patient about the use of intrauterine devices (IUDs).

Which of the following statements made by the patient indicates a need for further teaching?

The correct answer is choice C.“I can start the injections right after I give birth if I am not breastfeeding.” This statement indicates a need for further teaching because medroxyprogesterone injections should not be started until at leastsix weeksafter giving birth if the woman is not breastfeeding.Starting the injections earlier may increase the risk ofbleeding,blood clotsanddecreased milk production.

Choice A is correct because medroxyprogesterone injections are given every12 to 13 weeksfor contraception.

Choice B is correct because medroxyprogesterone injections may causebone lossover time, and calcium supplements may help prevent this.

Choice D is correct because medroxyprogesterone injections often reduce or stop menstrual bleeding by suppressing ovulation and thinning the lining of the uterus.

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.