2.1 Cs Exam4: Contraception

Front 1

what types of contraceptives are the most effective overall? which 2 are the least effective overall?

Back 1

most effective: implants, vasectomy, female sterilization and IUD
least: withdrawal and spermicide.

Front 2

what are the 6 contraceptive methods?

Back 2

periodic abstience (withdrawl, lactation, natural)
mechanical barriers
hormonal contraceptives
IUDs
sterilization
emergency contraception (postcoital)

Front 3

what are the advantages and disadvantages of coitus interruptus/ withdrawal?

Back 3

advantage: immediate availability, no device, no cost
disadvantage: pregnancy w/ incorrect use.

Front 4

how long is menses recorded for the calendar method?

Back 4

recorded for 6 cycles (6 months) to approximate the fertile period

Front 5

how do you calculate the fertile phase via the calendar method? what does the numbers mean?

Back 5

-subtract 18 from the shortest cycle --> first day of fertile phase
-subtract 11 from the longest cycle--> last day of fertile phase

avoid sex during those days.

Front 6

If the shortest cycle during the last 6 months was 25 days & the longest cycle was 35 days, when can the couple have sex (using calendar method)?

Back 6

Couple should not have sex during days 7 - 24 of womens cycle

25 - 18 = 7

35 - 11= 24

Front 7

who can use cycle beads? what is the use?

Back 7

women with 26 to 32 day menstrual cycles to recognize the 12 days each month that they are potentially fertile.

Front 8

how can mucus changes predict fertility?

Back 8

the thinner the mucus, the more fertile you are. The thicker the mucus, the greater the barrier.

(can have sex the 4 days after the mucus is thickest only)

Front 9

Basel body temp is relatively low during what phase? in what phase does it rise? why does it rise? when can you resume intercourse?

Back 9

BBT - low during follicular phase
Rises in the luteal phase d/t thermogenic effect of progesterone
elevated temp begins 1-2 days after ovulation and you can resume intercourse 3 days after temp rise.

Front 10

what type of contraception provides the most effective protection of the genital tract for STD's?

Back 10

male condom

Front 11

T/F

The reality (female) condom is recommended for use w/ the male condom.

Back 11

FALSE

they are NOT recommended because they adhere to each other.

Front 12

what are the advantages and disadvantages of the cervical cap?

Back 12

advantage: continuous contraceptive protection for the duration of use regardless of intercourse ( can be left in for 48 hrs)

disadvantage: requires visit for fitting, can cause cerical erosion, can dislodge w/ intercourse. Can also get Toxic shock syndrome.

Front 13

what is a diaphragm? How often should you add spermicide?

Back 13

a shallow latex cup w/ a spring mechanism in rim to hold it in place in the vagina. Add spermicide w/ each coitus.

Effective for 6 hrs as semen barrier

may cause toxic shock

Front 14

what chemical basis do spermicidal agents contain?

Back 14

base combined w/ either nooxynol-9 or octoxynol --> destroys sperm cell membrane and flagella

Front 15

what are the advantages and disadvantages of the spermicidal agents?

Back 15

advantages: reduces the risk of infection by both viral and bacterial organisms that cause STD's, ease of application, no adverse systemic effects.

disadvantages: minimal protection of STDs, irritation and allergic reactions. Must be inserted into the vagina prior to each coital act.

Front 16

what are the advantages and disadvantages of the of DMPA (injected contraceptive)?

Back 16

advantage: single dose suppresses FSH and LH for up to 14 weeks, 97% effective
disadvantage: unpredictable menstrual patterns, weight gain, reversible loss of bone mineral density, and some mood changes.

Front 17

what is the MOA of oral and implant contraceptives?

Back 17

inhibition of ovulation w/ suppression of FSH and LH levels eliminating the LH surge which results in a hypo estrogenic state.

Front 18

what is implanon?

Back 18

a single rod implant contraceptive w/ etonogestrel- assoc w/ higher frequency of amenorrhea, decreased adverse effects. Can keep it for 4-5 years and 99% efficacy.

Front 19

what are the advantages and disadvantages of the implanon?

Back 19

advantage: 99% efficacy, no effect on breast milk, rapid return of fertility state
disadvantage: minor surgical procedure for insertion and removal

Front 20

what form of oral contraceptive can you give to breastfeeding women? why?

Back 20

progestin-only "minipills"

-it suppresses ovulation, increases cervical mucus viscosity, thinning of endometrium and won't cross into the breast mild.

Front 21

what are the advantages and disadvantages of the progestin-only contraceptive pills?

Back 21

advantages: decreased dysmenorrhea, decreased PMS and endometriosis
disadvantages: continuous need for compliance (within 3 hours after the time of regular administration--> very tight time frame), breast tenderness, headache and amenorrhea.

Front 22

what are the advantages and disadvantages of the oral contraceptives (estrogen/progestin combo)?

Back 22

advantages: tx of menstural irregularities, reduce anemia secondary to menorrhagia, prevent benign conditions, prevent epithelial ovarian and endometrial cancer.
disadvantages: nausea, amenorrhea, venous thrombosis, htn, hepatocellular adenoma

Front 23

CI for oral contraceptives:

Back 23

cerebrovascular dz, coronary artery dz, deep vein thrombosis, pulmonary embolism, chf, estrogen-dependent neoplasia, breast ca, pregnancy, liver dz, over 35 and smoking cigarettes

Front 24

Describe the nuva ring.

Back 24

flexible colorless ring that releases hormones slowly absorbable by reproductive organs--> lowest dose of ethinyl estradiol. Same schedule as OCP- 3 on, 1 off.

Front 25

describe the hormonal patch.

Back 25

combo estrogen and progesterone released into skin- releases a sustained low daily dose of steroids equivalent to the lowest dose oral contraceptive

Front 26

what is the black box warning assoc w/ hormonal patch?

Back 26

that these women on the patch are exposed to about 60% more total estrogen in the blood then if they were taking an OCP.

Front 27

which IUD is effective for 10 years and which one for 5? Besides pt wishing not to get pregnant, who else could you give the Mirena to?

Back 27

copper (ParaGard)-10 yr effectiveness
mirena- 5 yr

Give Mirena to pt who is complaining of dysmenorrhea, PMS, or heavy bleeding

Front 28

what are the ways to sterilize a female? sterilze a male?

Back 28

surgical tubual, essure tubual

men: vasectomy

Front 29

what are the advantages and disadvantages of female sterilization?

Back 29

advantages: no hormones, permanent, same-day procedure
disadvantages: may involve general or regional anesthesia, permanent

(reversible w tubal reanastomosis but not 100% guarantee & difficult)

Front 30

what are the advantages and disadvantages of male sterilization?

Back 30

advantage: no hormones, permanent, outpatient
disadvantage: permanent.

Front 31

which emergency contraceptive pill is a 2 pill dose taken w/n the first 72 hours after unprotected intercourse w/ each pill taken 12 hours apart?

Back 31

preven

plan B is one dose no later than 72 hours after unprotected intercourse w/ second dose w/n 12 hours.

Front 32

which emergency contraceptive can you take within 5 days of unprotected intercourse?

Back 32

Ella

selective progesterone receptor