What is the first procedure a nurse practitioner should perform when preparing to insert an intrauterine contraceptive in a patient previously unexamined?

To understand the process of preparing for an intrauterine contraceptive (IUC) insertion, the first step is to conduct a bimanual examination. This examination allows the nurse practitioner to assess the size, position, and mobility of the uterus and to evaluate the adnexa for any abnormalities that may affect the insertion procedure. It is critical to perform this initial assessment to ensure that the patient is a suitable candidate for IUC placement and to identify any contraindications that might not be obvious through a routine history alone.

Following the bimanual examination, other procedures can be performed, such as cleaning the cervix with antiseptic and applying a tenaculum, which secures the cervix to facilitate the placement of the IUC. An ultrasound may also be used in certain situations, but it is typically not the first step in the preparation process, as the physical examination already provides significant information regarding the anatomy that is essential for safe insertion.