A nurse is reviewing the mechanism of action of IUDs with a group of nursing students.
Which of the following statements by a student indicates an understanding of the teaching?
“IUDs immobilize sperm and interfere with their migration from the vagina to the fallopian tubes.”.
“IUDs speed up the transport of the ovum through the fallopian tube.”.
“IUDs inhibit fertilization and cause lysis of the blastocyst.”.
All of the above
The Correct Answer is D
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.
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Correct Answer is B
Explanation
The correct answer is choice B. The client has a positive pregnancy test result.
This is a contraindication for bilateral tubal ligation because the procedure is a permanent form of contraception and should not be performed on a pregnant woman.
The client should be counseled about other options for birth control or termination of pregnancy.
Choice A is wrong because a history of pelvic inflammatory disease is not a contraindication for bilateral tubal ligation.It may increase the risk of complications from the surgery, such as infection or adhesions, but it does not prevent the procedure from being performed.
Choice C is wrong because a family history of breast cancer is not a contraindication for bilateral tubal ligation.It may affect the client’s decision to undergo the procedure, as some studies have suggested that tubal ligation may reduce the risk of ovarian cancer, which is associated with breast cancer.
However, this is not a medical reason to avoid the surgery.
Choice D is wrong because a history of endometriosis is not a contraindication for bilateral tubal ligation.
It may cause pelvic pain or infertility, but it does not affect the effectiveness or safety of the procedure.In fact, some studies have shown that tubal ligation may improve the symptoms of endometriosis by reducing retrograde menstruation.
Correct Answer is C
Explanation
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.
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