A nurse is teaching a client who is considering female sterilization as a contraceptive method.

Which of the following statements by the nurse is appropriate?

The correct answer is choice D.“You should wait until your baby is 6 weeks old before starting the injections.” This is because medroxyprogesterone may pass into breast milk and cause side effects in a child who is breastfed.The product labeling states that it should be started no sooner than 6 weeks postpartum, based on data submitted for product approval.

The World Health Organization also recommends that injectable depot medroxyprogesterone acetate should not be used before 6 weeks postpartum.

Choice A is wrong because starting the injections immediately after delivery could interfere with the exclusivity or duration of lactation, and could affect the newborn infant adversely because of slower metabolism of the drug than older infants.

Choice B is wrong because waiting until the baby is 6 months old is unnecessary and could expose the mother to a higher risk of unintended pregnancy.

Choice C is wrong because medroxyprogesterone has not been known to cause any decrease in milk supply while using the injections

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.