RN Nursing · Prenatal Care · Practice question
A nurse is reinforcing teaching about diaphragms with a client. Which of the following statements by the client indicates an understanding of the teaching?
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✓
"I will leave the diaphragm in for at least 6 hours after vaginal intercourse."
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"I will avoid using creams or jellies so that the diaphragm will fit snugly."
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"I will need to get a new diaphragm every year."
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"I will coat the diaphragm with an oil-based lubricant in between uses."
Answer & explanation
Correct: "I will leave the diaphragm in for at least 6 hours after vaginal intercourse."
A diaphragm must remain in place for at least 6 hours after the last act of vaginal intercourse to ensure that any sperm present are immobilized or destroyed by the accompanying spermicide. Removing it too early risks contraceptive failure. This statement correctly reflects the recommended practice and demonstrates understanding of the teaching. Regarding creams and jellies: spermicidal cream or jelly is actually required with a diaphragm and must be applied inside the dome and around the rim before insertion; avoiding it would significantly reduce effectiveness. Concerning replacement frequency, diaphragms should be replaced approximately every two years, not every year, and also after weight changes of 10 or more pounds, pregnancy, or pelvic surgery. The fit is checked by a provider, not simply replaced annually. Regarding lubricants, only water-based lubricants are compatible with latex diaphragms between uses; oil-based lubricants degrade latex and can cause the device to break down, compromising its barrier function. Therefore, coating with an oil-based lubricant is incorrect and potentially harmful. The only statement that reflects accurate knowledge is that the diaphragm should be left in for at least 6 hours following intercourse.
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