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

Inserting an indwelling urinary catheter is not the priority nursing action in this situation. While it may be necessary later in the care process, it is not the immediate concern when the client is experiencing a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. The priority is to stabilize the client and ensure the well-being of the fetus.

Choice B rationale

Witnessing the signature for informed consent for surgery is an important step before any surgical procedure. However, it is not the priority nursing action in this situation. The client’s condition could deteriorate rapidly due to the bleeding, and immediate medical interventions are necessary to stabilize the client and fetus.

Choice C rationale

Preparing the abdominal and perineal areas may be necessary if the client requires a surgical intervention. However, this is not the priority nursing action. The client is experiencing significant bleeding, and the priority is to stabilize the client’s condition.

Choice D rationale

Initiating IV access is the priority nursing action in this situation. The client is experiencing a large amount of painless, bright red vaginal bleeding, which could lead to hypovolemia and shock. IV access allows for the rapid administration of fluids and medications to stabilize the client’s condition.

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.