A nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive (COC). The nurse recognizes that which of the following client medications can interfere with the effectiveness of the COC?

Choice A rationale

Bleeding or spotting can accompany implantation. This is a common occurrence and does not necessarily indicate a problem with the pregnancy. It happens when the fertilized egg attaches to the lining of the uterus. Some women may mistake this bleeding for a light period, but it’s a sign of pregnancy.

Choice B rationale

Fertilization typically takes place in the outer third of the fallopian tube. After ovulation, the egg travels down the fallopian tube towards the uterus. If sperm are present in the fallopian tube at this time, fertilization can occur. This is a normal part of the reproductive process.

Choice C rationale

Sperm can remain viable in the woman’s reproductive tract for 2 to 3 days. This means that intercourse does not have to coincide exactly with ovulation in order to achieve pregnancy. The sperm can survive long enough to fertilize the egg when it is released.

Choice D rationale

The statement “Implantation occurs between 2 and 3 weeks after conception” is incorrect and requires intervention by the nurse. Implantation actually occurs about 6-10 days after ovulation, which is less than 2 weeks after conception.

Choice A rationale

Moderate exercise improves circulation. This statement is accurate and should be included in the teaching. Regular moderate exercise during pregnancy can have many benefits, including improved circulation, which can help reduce swelling and varicose veins. It can also help manage weight gain, improve mood and energy levels, reduce pregnancy discomfort, prepare the body for labor, and boost stamina for labor and delivery.

Choice B rationale

Refrain from exercises that include stretching. This statement is not accurate and should not be included in the teaching. Stretching exercises can be beneficial during pregnancy. They can help improve flexibility, reduce muscle tension, alleviate pregnancy discomfort, and prevent muscle imbalances. However, pregnant women should be careful not to stretch too far, as the hormones produced during pregnancy can make the ligaments more flexible and easier to stretch, increasing the risk of injuries.

Choice C rationale

It is recommended to rest for 30 minutes before each new exercise. This statement is not accurate and should not be included in the teaching. While it’s important for pregnant women to rest and avoid overexertion, there’s no specific recommendation to rest for 30 minutes before each new exercise. Instead, pregnant women should listen to their bodies and rest as needed.

Choice D rationale

It is recommended to increase your weight-bearing exercises. This statement is not accurate and should not be included in the teaching. While weight-bearing exercises can be beneficial, they should be done with caution during pregnancy. Pregnant women should avoid heavy weights and exercises that put pressure on the joints, increase the risk of injury, or cause discomfort. Instead, they should focus on exercises that strengthen the muscles and improve balance and flexibility.