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
Explanation
Choice A rationale
Ensuring the newborn has a successful latch is crucial for preventing and treating sore and cracked nipples. A poor latch can cause nipple trauma and pain.
Choice B rationale
Increasing the length of time between feedings is not recommended as it can lead to engorgement and further complications. Frequent breastfeeding helps maintain milk supply and prevents issues like mastitis.
Choice C rationale
Applying mineral oil to the nipples is not recommended. Instead, using expressed breast milk or medical-grade lanolin can promote healing.
Choice D rationale
Keeping the nipples covered between breastfeeding sessions is not necessary and can sometimes exacerbate the problem. Allowing the nipples to air dry or using hydrogel pads can be more beneficial.
Correct Answer is D
Explanation
Choice A rationale
Changing the dressing on a cesarean incision for a patient who is 1 day post-op requires sterile technique and assessment skills, which are beyond the scope of practice for assistive personnel (AP). This task should be performed by a licensed nurse.
Choice B rationale
Documenting the lochia amount on the perineal pad of a client who just transferred from labor and delivery involves assessment and documentation, which are nursing responsibilities. This task should not be delegated to AP.
Choice C rationale
Assessing an area of redness on the breast of a client who is 4 days postpartum requires clinical judgment and assessment skills, which are within the scope of practice for a licensed nurse. This task should not be delegated to AP.
Choice D rationale
Providing a sitz bath to a client who has a third-degree laceration and is 2 days postpartum is an appropriate task for AP. It is a comfort measure that does not require clinical judgment or assessment skills, making it suitable for delegation to AP.