A nurse is providing teaching to a client who is postpartum and interested in information about contraception. Which of the following instructions should the nurse include?
The lactation amenorrhea method is effective for planned contraception up to 12 months postpartum.
Place the transdermal contraceptive patch on your upper arm or back.
You can continue to use the same diaphragm you used before pregnancy.
Start oral contraceptives immediately after delivery to ensure effectiveness.
The Correct Answer is B
Choice A reason: The lactation amenorrhea method is effective only up to 6 months postpartum, and only if exclusive breastfeeding and amenorrhea are maintained. It is not reliable for 12 months, so this statement is inaccurate, making it incorrect for contraception teaching.
Choice B reason: Placing the transdermal contraceptive patch on the upper arm or back ensures proper adhesion and absorption. This aligns with manufacturer guidelines for effective contraception, making it a correct and appropriate instruction for postpartum clients seeking reliable methods.
Choice C reason: A diaphragm used before pregnancy may no longer fit due to pelvic changes post-delivery. It requires refitting 6 weeks postpartum, so continuing use without adjustment is ineffective and risky, making this incorrect.
Choice D reason: Starting oral contraceptives immediately after delivery is not recommended, especially for breastfeeding mothers, due to risks like reduced milk supply or thromboembolism. Initiation typically begins 3-6 weeks postpartum, making this incorrect and unsafe.
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Correct Answer is B
Explanation
Choice A reason: Comparing the medication label to the provider’s prescription three times is a safety step during administration, not reconciliation. Reconciliation verifies the client’s home medications against new orders to prevent errors like omissions or duplications. This action occurs post-reconciliation, focusing on administration accuracy, not the initial verification of the medication list.
Choice B reason: Medication reconciliation involves comparing the client’s home medication list to admission prescriptions to ensure continuity and accuracy. This process identifies discrepancies, such as missed medications or incorrect doses, preventing adverse drug events. It requires verifying with the client or family and cross-checking provider orders, making it the cornerstone of safe transitions in care settings.
Choice C reason: Administering medications to treat a condition to the actual prescriptions is unclear and not part of reconciliation. Reconciliation focuses on verifying and documenting medications, not administering them. This option does not align with the systematic process of ensuring all medications are correctly prescribed upon admission, making it incorrect.
Choice D reason: Ensuring administration within 3 hours of the scheduled time relates to medication administration protocols, not reconciliation. Reconciliation verifies the accuracy of the medication list before administration. This step is about timing, not the verification process critical to preventing errors during care transitions, rendering it irrelevant to the task.
Correct Answer is C
Explanation
Choice A reason: Dehydration is not directly associated with gastroesophageal reflux, which involves gastric acid backflow. Dehydration affects fluid balance, not reflux mechanisms, so this statement is inaccurate and irrelevant to preterm contractions, making it incorrect.
Choice B reason: Dehydration is not caused by decreased hemoglobin and hematocrit; rather, it may elevate these due to hemoconcentration. This statement reverses the relationship, making it factually incorrect and unrelated to preterm labor risks.
Choice C reason: Dehydration can increase preterm labor risk by reducing uterine blood flow and triggering contractions via oxytocin release. This evidence-based link supports hydration as a preventive measure, making it the correct statement for teaching in this scenario.
Choice D reason: Dehydration is treated with fluid replacement, not calcium supplements, which address bone health or specific deficiencies. This treatment is irrelevant to dehydration or preterm labor, making it an incorrect and inappropriate recommendation.
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