Lippincott's; Q&A Review for NCLEX-RN; Tenth Edition; Chapter 1; The Nursing Care of the Childbearing Family; Antepartal Care

Lippincott's; Q&A Review for NCLEX-RN; Tenth Edition; Chapter 1; The Nursing Care of the Childbearing Family; Antepartal Care Leave the first rating Students also studied Terms in this set (5) Science MedicineObstetrics Save

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NCLEX: Contraceptive

14 terms timoteeyPreview Respira 59 terms Dia A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency contraception. After unprotected intercourse, the client calls the clinic to ask questions about taking the contraceptives, The nurse realizes the client needs further explanation when she makes which of the following responses?

• "I can wait 3 to 4 days after intercourse to start taking

these to prevent pregnancy."

• "My boyfriend can buy Plan B from the pharmacy if he

is over 18-years-old."

• "The birth control works by preventing ovulation or

fertilization of the egg."

• "I may feel nauseated or have breast tenderness or a

headache after using the contraceptive." "I can wait 3 to 4 days after intercourse to start taking these to prevent pregnancy." Plan B is a series of contraceptive pills similar in composition to birth control pills that have been used for the past 30 years. Plan B is the brand name for levonorgestrel 0.75 mg. Pills are most effective if taken immediately after unprotected intercourse and then again 12-hours later. Males can purchase this contraceptive as long as they are over 18-years of age. Common side effects include nausea, breast tenderness, vertigo, and stomach pain.

Am antenatal G 2, T 1, P 0, Ab 0, L 1 client is discussing her postpartum plans for birth control with her health care provider. In analyzing the available choices, which of the following factors has the greatest impact on her birth control options?

• Satisfaction with prior methods
• Preference of sexual partner
• Breast- or bottle-feeding plan
• History of clotting disease

Breast- or bottle-feeding plan Birth control plans are influenced primarily by whether the mother is breast- or bottle-feeding her infant. The maternal milk supply must be well established prior to the initiation of most hormonal birth control methods. Low dose oral contraceptives would be the exception. Use of estrogen/progesterone based pills and progesterone only pills are commonly initiated 4 to 6 weeks postpartum because the milk supply is well established by this time. Prior experiences with birth control methods have an impact on the method chosen as does the preference of the client's partner; however, they are not the most influential factors. A history of blood clots or thrombophlebitis is the second most important factor as several methods will be eliminated because of their potential to place the client at risk for clotting disorders.After the nurse instructs a 20-year-old nulligravid client on how to perform a breast self-examination, which of the following client statements indicates that the teaching has been successful?

• "I should perform breast self-examinations on the day

my menstrual flow begins."

• "Its important that I perform breast self-examination on

the same day each month."

• "If I notice that one of my breasts is much smaller than

the other, I should worry."

• "If there is discharge from my nipples, I should call my

health care provider." "If there is discharge from my nipples, I should call my health care provider." The nurse determines that the client has understood the instructions when the client says she will notify her physician if she noticed discharge or bleeding because this may be symptomatic of underlying disease. Ideally, breast self- examination should be performed about 1 week after the onset of menses because hormonal influences on breast tissue are at a low ebb at this time. The client should perform breast self-examination on the same day each month only if she has stopped menstruating (as with menopause). The client's breasts should mirror each other. If one breast is significantly larger than the other, or if there is "pitting" of breast tissue, a tumor may be present.An assessment of a 16-year-old nulligravid client who visits the clinic and asks for information on contraceptives reveals a menstrual cycle of 28-days. The nurse formulates a nursing diagnosis of Deficient knowledge related to ovulation and fertility management. Which of the following would be important to include in the teaching plan for the client?

• The ovum survives for 96 hours after ovulation, making

conception possible at this time.

• The basal body temperature falls at least 0.2° F after

ovulation has occurred.

• Ovulation usually occurs on day 14, plus or minus 2

days, before the onset of the next menstrual cycle.

• Most women can tell they have ovulated because of

severe pain and thick, scant cervical mucus.Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.For a client with a menstrual cycle of 28-days, ovulation usually occurs on day 14, plus or minus 2-days, before the onset of the next menstrual cycle. Stated another way, the menstrual period begins about 2-weeks after ovulation has occurred.Ovulation does not usually occur during the menses component of the cycle when the uterine lining is being shed. In most women, the ovum survives about 12 to 24 hours after ovulation, during which time conception is possible. The basal body temperature rises 0.5° to 1.0° F when ovulation occurs. Although some women experience some pelvic discomfort during ovulation (mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus is thin and copious.Which of the following instructions about activities during menstruation would the nurse include when counseling an adolescent who has just begun to menstruate?

• Take a mild analgesic if needed for menstrual pain.
• Avoid cold foods if menstrual pains persist.
• Stop exercising while menstruating.
• Avoid sexual intercourse while menstruating.

Take a mild analgesic if needed for menstrual pain.The nurse should instruct the client to take a mild analgesic, such as Ibuprofen, if menstrual pain or "cramps" are present. The client should also eat foods rich in iron and should continue moderate exercise during menstruation, which increases abdominal tone. Avoiding cold foods will not decrease dysmenorrhea. Sexual intercourse is not prohibited during menstruation, but the male partner should wear a condom to prevent exposure to blood.