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?

The nurse should include all of the following information in the teaching:

• The typical failure rate for IUDs is 1% to 3% per year.
• This means that out of 100 women who use an IUD for a year, one to three may get pregnant.
• The risk of pelvic inflammatory disease (PID) is highest in the first 6 weeks after insertion.
• PID is an infection of the reproductive organs that can cause infertility, chronic pain, or ectopic pregnancy.
• The risk of PID is higher if the woman or her partner has multiple sexual partners or a sexually transmitted infection (STI).
• The IUD can be inserted at any time during the menstrual cycle.
• However, some doctors may prefer to insert it during or right after the period, when the cervix is more open and the chance of pregnancy is lower.

Choice A is wrong because it only states one piece of information that the nurse should include in the teaching.

Choice B is wrong because it only states one piece of information that the nurse should include in the teaching.

Choice C is wrong because it only statesone piece of information that the nurse should include in the teaching

The correct answer is choice A. The nurse should assess for signs of pelvic inflammatory disease (PID), which is an infection of the female reproductive organs that can be caused by sexually transmitted bacteria.PID can cause abdominal pain during sexual intercourse, as well as other symptoms such as fever, unusual vaginal discharge, and bleeding between periods.PID can lead to serious complications such as infertility and ectopic pregnancy if left untreated.

Choice B is wrong because checking the string length of the IUD is not a priority action.The string length may change due to normal variations in the position of the uterus and cervix, and does not indicate a problem with the IUD.However, if the string is missing or longer than usual, it may suggest that the IUD has moved or expelled, and the client should see a provider.

Choice C is wrong because advising the client to use a backup contraceptive method is not a priority action.The IUD is a highly effective form of birth control that does not require additional methods unless the client wants to prevent STIs.However, if the client has an STI that causes PID, using a condom may help prevent further infection and transmission.

Choice D is wrong because scheduling an appointment for IUD removal is not a priority action.The IUD does not cause PID, but it may increase the risk of infection shortly after insertion, especially if the client has an STI.The risk of PID from IUD use is very low (less than 1%) and usually disappears after 3 weeks of placement.Removing the IUD may not cure PID and may expose the client to unwanted pregnancy.