Common side effect of Cu-T?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Obstetrics & Gynaecology

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

Bleeding is the most frequently reported side effect by women using a Copper-T (Cu-T) and is the leading cause for discontinuation of the method.
This side effect can manifest as menorrhagia (heavier menstrual periods), prolonged bleeding, or intermenstrual spotting.
The copper in the device causes a local inflammatory reaction in the endometrium, which is believed to be the primary cause of the increased bleeding.
While other side effects occur, bleeding is consistently documented as the most common complaint.

Option A: Pain, often in the form of cramping (dysmenorrhea), is a known side effect but is considered the second most common after bleeding.
Option C: An increase in vaginal discharge is not a primary or common side effect of the Cu-T itself. It is more often a symptom of an underlying infection, such as Pelvic Inflammatory Disease (PID).
Option D: Pelvic inflammation, or Pelvic Inflammatory Disease (PID), is a serious but relatively uncommon complication associated with IUD use. The risk is highest in the first few weeks after insertion and is much lower than the incidence of bleeding or pain.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Side effects of Copper-T (Cu-T) intrauterine device as background academic context rather than a clinical decision trigger.
Nurses must provide thorough counseling to patients considering a Cu-T, emphasizing that changes in their bleeding pattern are very likely, especially in the first 3-6 months. This manages expectations and improves continuation rates.
It is important to assess for contraindications like anemia or menorrhagia before recommending a Cu-T, as the device can exacerbate these conditions.
Patients should be instructed to report signs of excessive bleeding (e.g., soaking through a pad or tampon every hour for several hours), severe pain, fever, or foul-smelling discharge, as these could indicate a more serious complication.

How to Approach the Question

First, identify the core of the question, which is asking for the 'common' side effect of a 'Cu-T'.
Recall the mechanism and known effects of a Copper-T IUD. It is a non-hormonal device that works by creating a local inflammatory reaction.
Consider the provided options: Pain, Bleeding, Vaginal discharge, and Pelvic inflammation.
Differentiate between common, expected side effects and less common, more serious complications. Bleeding and pain are common side effects, while pelvic inflammation is a less frequent complication.
Based on clinical knowledge and evidence, recall that increased menstrual bleeding is the single most reported side effect and the most common reason for discontinuation.
Therefore, select 'Bleeding' as the most accurate answer.

Concept Tested & Keywords

QrujM7MUPae8FJ5ozJu5xw

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) pp. 191-193, 192-194

E6 Obstetrics Williams p. 74-95