A patient calls a family planning clinic and tells the nurse that ...

[JMatthes]

A patient calls a family planning clinic and tells the nurse that her vaginal ring, which has been in place for 2 weeks, came out sometime during the night while she was sleeping. The nurse will instruct her to:
 
  a. clean the ring with warm water, reinsert it, and use condoms for 7 days.
  b. discard the ring and insert a new ring after 1 week has passed.
  c. discard the ring and insert a new one to begin a new cycle.
  d. wash the ring in hot, soapy water and reinsert it.

Question 2

A female patient who is not taking any other medications is prescribed aliskiren Tekturna, a direct renin inhibitor (DRI). The nurse reviews medication information with the patient.
 
  Which statement by the patient indicates understanding of the teaching? a. If I get pregnant, I should stop taking this drug by the second trimester.
  b. If I take this drug with a high-fat meal, it will be more effective.
  c. I should restrict my potassium intake while taking this drug.
  d. I should take this medication 1 hour be-fore sitting down to a meal.

[joanwhite]

Answer to Question 1

A
If a ring is expelled before 3 weeks have passed, it can be reinserted after being washed in warm water. If the ring has been out longer than 3 hours, backup contraception should be used for 7 days. Because this ring was expelled while the patient was sleeping, using backup contraception is prudent. Discarding the ring is not indicated if it can be cleaned. The ring should not be washed in hot water.

Answer to Question 2

D
DRIs should be taken on an empty stomach to improve their bioavailability. Patients should not take this drug when pregnant and should stop immediately upon finding out they are pregnant. Dosing with a high-fat meal reduces the drug's bioavailability. DRIs rarely cause hyperkalemia when taken alone.

[JMatthes]

Thanks for the timely response, appreciate it

[Joy Chen]

YES! Correct, THANKS for helping me on my review