A nurse is teaching a client who is starting medroxyprogesterone injections for contraception.

Which of the following statements by the client indicates a need for further teaching?

The correct answer is choiceD.

All of the above.

Here is why:

• Choice A is correct because obtaining informed consent from the client is a necessary step before any invasive procedure, including IUD insertion.
• Choice B is correct because performing a Pap smear and cervical culture can help screen for cervical cancer and sexually transmitted infections, which are contraindications for IUD use.
• Choice C is correct because administering an analgesic medication can help reduce the pain and discomfort associated with IUD insertion, especially in nulliparous women who have a smaller cervical diameter.
• Choice D is correct because it includes all of the above actions, which are recommended by the American College of Obstetricians and Gynecologists (ACOG) for IUD insertion in nulliparous women.
• Choice A is wrong if it is the only action taken, because it does not address the other aspects of IUD insertion such as screening and pain management.
• Choice B is wrong if it is the only action taken, because it does not ensure the client’s consent and comfort during the procedure.
• Choice C is wrong if it is the only action taken, because it does not verify the client’s eligibility and suitability for IUD use.

The correct answer is choice A.Mennorhagia is a contraindication for the use of an intrauterine device (IUD) for contraception because it can cause heavy or prolonged menstrual bleeding.This can lead to anemia, infection, or expulsion of the device.

Choice B is wrong because ovarian cysts are not a contraindication for IUD use.They are usually benign and do not interfere with the placement or function of the device.

Choice C is wrong because fibrocystic breast disease is not a contraindication for IUD use.It is a common condition that causes benign lumps in the breast tissue and does not affect the hormonal balance or the risk of infection.

Choice D is wrong because endometriosis is not a contraindication for IUD use.In fact, some types of IUDs that release progestin can help reduce the symptoms of endometriosis by thinning the endometrial lining and suppressing ovulation.