A nurse is providing teaching to a client who has a new prescription for oral contraceptives (OCs).

Which of the following statements by the client indicates an understanding of how to initiate OCs?

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.

All of the above.

This is because IUDs have multiple mechanisms of action that prevent fertilization and implantation of the ovum.According to the search results, some of these mechanisms are:

• IUDs immobilize sperm and interfere with their migration from the vagina to the fallopian tubes.This is because copper ions released from copper IUDs are toxic for spermatozoa and impair their motility and viability.Hormonal IUDs also thicken the cervical mucus, which blocks sperm from entering the uterus.
• IUDs speed up the transport of the ovum through the fallopian tube.This is because IUDs induce a local inflammatory reaction in the endometrium, which affects the signaling between the uterus and the ovary and alters the tubal motility.This reduces the chances of fertilization by shortening the time window for sperm-egg interaction.
• IUDs inhibit fertilization and cause lysis of the blastocyst.This is because IUDs affect the function or viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed.IUDs also interfere with implantation of the fertilized ovum by creating a hostile environment in the uterine cavity.

Choice A is wrong because it only describes one mechanism of action of IUDs, not all of them.

Choice B is wrong because it only describes another mechanism of action of IUDs, not all of them.

Choice C is wrong because it only describes yet another mechanism of action of IUDs, not all of them.