A nurse is caring for a client who is considering several methods of contraception. Which of the following methods of contraception should the nurse identify as being most reliable?
An intrauterine device (IUD).
An oral contraceptive.
A male condom.
A diaphragm with spermicide.
The Correct Answer is A
Choice A rationale
An intrauterine device (IUD) is one of the most reliable methods of contraception. It is a small, T-shaped device inserted into the uterus by a healthcare provider. IUDs can be hormonal or non-hormonal (copper). Hormonal IUDs release progestin, which thickens cervical mucus to prevent sperm from reaching the egg and thins the uterine lining to prevent implantation. Copper IUDs release copper ions, which are toxic to sperm. Both types of IUDs are over 99% effective and can last for several years, making them a highly reliable form of contraception.
Choice B rationale
Oral contraceptives, commonly known as birth control pills, are also effective but require daily adherence. They contain hormones (estrogen and progestin) that prevent ovulation, thicken cervical mucus, and thin the uterine lining. However, their effectiveness can decrease with missed doses, certain medications, or gastrointestinal disturbances. With typical use, their effectiveness is around 91%, meaning 9 out of 100 women may become pregnant each year.
Choice C rationale
Male condoms are a barrier method of contraception that prevent sperm from entering the uterus. They are also effective in preventing sexually transmitted infections (STIs). However, their effectiveness can be compromised by improper use, breakage, or slippage. With typical use, male condoms are about 85% effective, meaning 15 out of 100 women may become pregnant each year.
Choice D rationale
A diaphragm with spermicide is a barrier method of contraception. The diaphragm is a shallow, dome-shaped cup inserted into the vagina to cover the cervix, and spermicide is applied to kill sperm. Its effectiveness depends on correct and consistent use. With typical use, diaphragms are about 88% effective, meaning 12 out of 100 women may become pregnant each year. Additionally, diaphragms do not protect against STIs.
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Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
Warm compresses can help to reduce perineal pain and swelling by increasing blood flow to the area, which promotes healing and provides comfort. The warmth can also help to relax the muscles and reduce discomfort.
Choice B rationale
Tucks pads, which contain witch hazel, are effective in reducing perineal pain and swelling. Witch hazel has anti-inflammatory and astringent properties that help to soothe irritated skin and reduce swelling, providing relief from discomfort.
Choice C rationale
Dermaplast spray is a topical anesthetic that provides temporary relief from perineal pain. It contains benzocaine, which numbs the area and reduces pain. It also has antiseptic properties that help to prevent infection in the perineal area.
Choice D rationale
Ibuprofen 600 mg PO is a nonsteroidal anti-inflammatory drug (NSAID) that helps to reduce pain and inflammation. It works by inhibiting the production of prostaglandins, which are chemicals that cause inflammation and pain. Taking ibuprofen can provide significant relief from perineal discomfort.
Choice E rationale
Encouraging the patient to sit in a high Fowler’s position is not recommended for perineal pain management. This position can increase pressure on the perineum, potentially worsening the pain and discomfort.
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale
Washing hands before and after perineal care or voiding is essential to prevent infection. Proper hand hygiene reduces the risk of introducing bacteria to the perineal area, which is particularly vulnerable to infection postpartum.
Choice B rationale
Leaving the current pad on until it is fully saturated is not recommended. Changing pads frequently helps to maintain cleanliness and reduce the risk of infection. A saturated pad can harbor bacteria and increase the risk of infection.
Choice C rationale
Wiping the perineum thoroughly with a back-and-forth motion is not recommended. Instead, the perineum should be wiped from front to back to prevent the spread of bacteria from the rectal area to the perineal area, reducing the risk of infection.
Choice D rationale
Using a perineal squeeze bottle to cleanse the perineum is recommended. It helps to gently clean the area without causing irritation or discomfort. The warm water can also provide soothing relief to the perineal area.
Choice E rationale
Applying ice or cold packs to the perineum can help to reduce swelling and provide pain relief. The cold temperature constricts blood vessels, reducing inflammation and numbing the area to alleviate discomfort.