A nurse is reviewing the medical history of a client who is considering using COCs as a method of contraception.

The nurse should identify that which of the following conditions is a contraindication for using COCs?

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 B.Spotting and irregular bleeding are potential adverse effects of the copper IUD.The copper IUD works by creating a toxic environment for sperm and eggs in the uterus and cervix, but it does not affect the hormones that regulate the menstrual cycle.Therefore, it can cause changes in bleeding patterns, such as heavier, longer or more painful periods.

Choice A is wrong because decreased bone density is not a side effect of the copper IUD.It is a possible side effect of hormonal IUDs that contain progestin, which can lower estrogen levels and affect bone health.

Choice C is wrong because mood changes are not a side effect of the copper IUD.They are more likely to occur with hormonal methods of birth control that affect the levels of estrogen and progesterone in the body.

Choice D is wrong because headaches are not a side effect of the copper IUD.They are also more common with hormonal methods of birth control, especially those that contain estrogen.