CPM Certified Professional Midwife

Category - Midwifery Counseling and Education

A midwife is creating a teaching plan for a client who is scheduled for tubal ligation. Which of the following teachings should not be included in the plan?
  1. Avoid unprotected coitus before the surgical procedure.
  2. The procedure will not affect the menstrual cycle.
  3. Coitus may be resumed 3 days after the procedure.
  4. Occurrence of sharp shoulder pain necessitates immediate medical intervention.
Explanation
Answer: D - The occurrence of sharp shoulder pain may be expected after the surgery. Tubal ligation involves infusion of carbon dioxide into the incision to lift the abdominal wall upward. Until carbon dioxide is absorbed, the client may experience abdominal bloating and sharp shoulder pain for the first 24 hours. Unprotected coitus is avoided because the sperm may get trapped in the tube and fertilize an ovum, causing ectopic pregnancy. In contrast to hysterectomy, tubal ligation does not affect the menstrual cycle. Coitus is safe three days after the procedure.
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