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77 Cards in this Set
- Front
- Back
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What are the factors affecting family planning?
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1. Sociocultural
2. Occuptational/economic 3. Religious 4. Legal 5. Physical 6. relationship 7. psychological 8. current health status/genetics |
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What is the acronym for informed consent?
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BRAIDED
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What is B.R.A.I.D.E.D stand for?
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B-benefits
R- risks A- alternatives I- Inquiries (opportunities to ask questions) D - Decision E- explanation D- documentation |
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What are the major contraceptive methods?
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1. Natural family planning
2. Barrier Methods 3. Spermicides 4. Hormonal Methods 5. IUD 6. Sterilization |
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What is the most popular form of birth control in the US?
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Oral contraceptives
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What is the most effective form of birth control?
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abstinence
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What is the purpose of the Fertility awareness method?
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to identify the beginning and end of the fertile period of the menstrual cycle
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What phases are women educated about using the Family awareness method?
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-Infertile phase:
-Fertile phase:5-7 days around middle of the cycle -Infertile phase: after ovulation |
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What is Natural Family Planning?
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Method of contraception that relies on understanding of conception, menstrual cycle and periods of fertility.
-provides contraception by using methods that rely on avoidance of intercourse during fertile periods |
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What are the benefits to NFP?
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-Inexpensive
-No drugs or hormones -Convenient and easy to use -Helps a woman to understand her body |
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List the disadvantages of NFP?
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-No protection from STDs
-Requires high motivation and extensive education -abstinence necessary for large part of each cycle. |
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How many days before and after ovulation on average must a couple abstain in NFP?
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4 before and 4 after ovulation
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What are some of the methods used by couples practicing NFP?
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1. Rhythym method
2. casal body tem method 3. cervical mucus method 4. Symptothermal method (combination of all) |
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How long does it take to determine the fertile period when practicing NFP?
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after 6 month of recording regular and predictable cycles
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What is the equation used for the calendar method to determine the fertile period?
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Length of shortest cycle -18 days: start of the fertile period
Length of the longest cycle -11: end of the fertile period |
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What is the basal body temp?
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the lowest body temperature of a healthy person, taken immediately after waking and before getting out of bed
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What is temp rise during ovulation?
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.5-1 F or 0.2C- 0.4C
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What are some factors that affect temperature?
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Alcohol, # of hours of sleep, infection
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In the cervical mucus method, when would you tell the woman to start tracking her mucus?
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Start on the last day of her menstrual flow
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What is the name of fertile mucus? What is the consistency?
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Spinnbarkhelt
-consistency of egg whites |
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What is the symptothermal method?
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Combination of BBT, CMM and menstrual cycle symptoms
Much more effective than others alone |
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What are the requirements for the standard Days method (SDM)?
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Must have cycle every 26-32 days
-Fertile days 8-19 --avoid unprotected intercourse on days 8-19 -Bead method |
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What does the predictor test for ovulation indicate?
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Detects LH surge prior to ovulation
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Why is the predictor test for ovulation better than BBT or CMM?
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because it is not affected by illness, emotional upset or physical activity
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What is pre-ovulation mucus like?
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Thick, cloudy, yellow, white or sticky
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Describe ovulation mucus.
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Clear, wet, sticky and slippery
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When is intercourse considered safe according to the mucus?
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Following the last day of wet, clear, slippery mucus (post-ovulation)
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List all the types of barrier methods?
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-condom (male and femal)
-diaphragm -cervical cap -contraceptive sponge -spermicides |
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What is important to consider with male condoms?
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Must counsel about proper use/application
-apply the condom on the penis after it is erect and before intimate contact |
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What type of lubricant is required to use with condoms?
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Must used water based products such as KY jelly. Do not use petroleum based products because they can cause the condom to break
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What are the counseling factors for female condoms?
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-Female controlled
-can insert 8h prior - must remove after |
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Which barrier for contraception requires a fitting?
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Diaphragm and cervical cap
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When must a diaphragm be re-fitted?
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every 2 years of with excessive gain or weight loss
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WHat is the only way to get a diaphragm?
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by Rx only
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How long must a diaphragm be left in after intercourse?
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6 hours
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How does the diaphragm work>?
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by covering the cervix to prevent sperm from entering and by killing the sperm with spermicide application
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What are the side effects/risks of diaphragms?
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the efficacy diminishes w/increased frequency of intercourse
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Describe the features and use of the cervical cap.
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NO LONGER USED IN THE US
-fitting, use, and efficacy are similar to diaphragm -must be used with spermicide -efficacy decreases with parity |
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What are the 2 other cervical barriers that are similar to diaphragm and the cap?
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Lea's shield and FemCap
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What are the factors of the sponge?
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-female controlled
-available OTC -insertion and removal |
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What is the most commonly used spermicide in the US?
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N-9
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What is N-9?
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Spermicide
-surfactant that destroys the sperm cell membrane on the surface |
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What is the pathway of hormonal contraceptives?
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Synthetic estrogen and progesterone --> estrogen --> suppresses production of FSH and LH --> Suppression of ovulation
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What is the MOA for Combined Hormonal Contraceptives?
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1. Suppression of ovulation
2. Endometrium remains thin 3. Cervical mucus thickens |
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LIst the contraindications for hormonal contraceptive use.
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1. Thromboembolitic disorders
2. Coronary artery disease or cerebral vascular disease 3. Sever diabetes 4. Breast ca 5. estrogen dependent ca 6. pregnancy 7. HTN 8. currently impaired liver function or liver tumor 9. lactation 10. smoking > 35 yro 11. migraines with neurological symptoms (auras) |
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What are some side effects of estrogen excess from hormonal contraceptives?
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-nausea
-vomiting -dizziness -edema -increase in breast size -chloasma -visual changes -HTN -vascular HA |
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An estrogen deficiency when taking COC would cause what symptoms?
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-early spotting ( days 1-14)
-hypomenorrhea -nervousness -vaginal dryness |
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Late spotting, heavy blood flow with clots and decreased breast size are sides effects of which COC category?
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Progestin deficiency
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In progestin excess, what side effects are seen?
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-Increased appetite
-tiredness -depression -breast tenderness -oily skin and scalp -hirsuitism |
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What acronym is used to remember the Hormonal contraception warning signs?
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ACHES
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What are ACHES?
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hormonal contraceptive warning signs
A-abdonminal pain C- chest pain H-headache (sudden or persistent) may be CV or HTN E- eye changes S- severe leg pain |
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When is a woman counseled to start her COC?
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Begin taking the pill on the FIRST SUNDAY after the menses starts
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What is OrthoEvra?
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The tansdermal contraceptive patch that delivers continuous levels of hormones to the body for a week at a time
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Describe contraception by combined injection.
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Called Lunelle (IM injection monthly)
-Not available in the US -Prevents ovulation, works the same way as the pill, path or ring |
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What is Araujo's favorite form of birth control?
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The Ring! NuvaRing
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What must a woman be counseled about when using the nuvaring?
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-Insertion
-change day -the ring is thought to be as effective as OCs -the first time the ring is used, it is inserted DURING the first 5 days of menstruation -Effectiveness of the ring is lowered when taken with certain meds |
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What is the advantage for most women using extended use OCs?
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They will have no period for months at a time
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For Seasonale, how many weeks of active pills are taken? How many inactive?
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12 weeks active
1 week inactive |
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What are the characteristics of Progestin only contraceptives?
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-Eliminates side effects of estrogen
-MOA -inhibits ovulation -thickens and decreases the amount of cervical mucus -Thinning of the endometrium |
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What counseling information must be given when Rx for the mini-pill is given?
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-Initiation time
-Timing/missed pills (Must take at the same time EVERYDAY and must not miss a pill -Side effects |
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What are emergency contraceptives composed of?
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High doses of oral contraceptives that prevent ovulation or implantation
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How effective are ECs?
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75-89% effective
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How many hours is typical to give EC's?
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72-120 post intercourse
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If ECs are given to a woman who has an implanted fetus, will the EC have an effect on the baby?
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No
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What is the MOA of intraueterine contraception?
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-Damages sperm in transit to tubes
-Uterine lining inhospitable -Effect mucus and endometrial maturation |
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What are the 2 types of IUDs?
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-Copper T: approved for 10 years (Paragard)
-progesteron based: approved for 5 years (mirena) |
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What are the contraindications for Copper T?
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-not monogamous
-pregnant -HIV + -undiagnosed vaginal bleeding -pelvic infections -recent endometritis -uterine/cervical ca -Allergy to copper |
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What are the actions of mirena?
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-thickens cervical mucus
-impairs sperm migration -alters the endometrium to prevent implantation -inhibits ovulation |
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What are the contraindications for Mirena specifically?
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-Breast Ca
-Undiagnosed vaginal bleeding -Liver disease |
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What are the contraindications for All IUDs?
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-Recent history of PID
-Known or suspected pregnancy -Undiagnosed genital bleeding -Suspected genital malignancy -Distorted uterine cavity -Not in monogamous relationship -HIV |
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How can you test for the warning signs of IUDs?
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Use PAINS
P-period late (paragard has no hormones so you get a period) A- abdominal pain I- infection exposure N-not feeling well S-string missing, shorter or longer |
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What are the male and female forms of sterilization called?
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Vasectomy and Tubal ligation
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What must a man be counseled about following a vasectomy?
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Must use alternative birth control until he is certain that is sperm reserve is depleted. May take up to 3 months and 20 ejaculations
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What % of pregnancies are unintended in the US each year?
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49%
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What are the two categories of induced abortion?
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Elective or therapeutic
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When is a medical abortion done and how is it completed?
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Done < or equal to 7-9 weeks gestation
-Typically done with meds to induce an abortion |
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List the types of surgical abortions and at what weeks they can occur?
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1. Manual vacuum aspiration < 10 wks
2. Dilation and curretage (D+C) < 14 weeks 3. Dilation and evacuation (D+E) up to 20 wks |
