Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
35 Cards in this Set
- Front
- Back
|
medical questions to ask
|
“What are you doing to prevent pregnancy?”
“Have you tried birth control in the past?” “Were you happy with that method?” |
|
|
ask about medical conditions
|
1. blood clots
2. heart problems, liver problems 3. breast problems 4. abnl pap 5. stds 6. pregnancy within last 6 weeks 7. smoke? 8. # of partners |
|
|
best birth control is...
|
the one that is medically appropriate and is used correctly and consistently by someone who is happy with the method.
|
|
|
ineffective methods
|
Postcoital douching, Postcoital uination, Altered sex positions
|
|
|
plan B
|
- effective up to 5 days after
-does not harm or abort an exicsting preg -safe, no side effects -< 18 need prescription -2 pills taken 12 hrs apart -alters fallopian ciliary action, thickens mucosa, renders endometrium inhospitable to implantation -can use OCs instead but will have sides effects, pre-medicate with emitrol then take 4 low does OCs and repeat in 12 hrs |
|
|
withdrawal
|
-5-50% failure rate
-requires self control -not for teens -diminses sexual pleasure -re-ejac may contain sperm |
|
|
outercourse
|
sex play with not sex
-consder for partners with heavy stds or hiv |
|
|
condom
|
-15% failure rate
|
|
|
female condom
|
-20% failure rate
-spotty availability, cost $3 |
|
|
calendar method
|
avoid having sex from day 9-19
|
|
|
basal body temp
|
daily am temps; post ovulatory temps rises .5 deg to 1 deg for 3 more days; absitnence on first day of menstrual bleeding until 3 days after temp rise
|
|
|
mucous thinning
|
evaluate thin watery mucous = absitnence for 4 days
|
|
|
diaphragm
|
-15-20% failure rate
-consider for pts whose partners are HIV positive -cost inner surface 1/3 full with spemacide up to 6 hours before coitus -leave in for 6 hours after -can be left for 24 hrs |
|
|
spermicides
|
Delfen foam:
today sponge: |
|
|
combined oral contraceptive pills: estrogen and progesterone
|
-95% effective
-side effect: maybe nausea and headache -improve acne, regulates menses, shorter ligther periods, less cramps -protective against ovarian and endometrial cancer |
|
|
BC pills how does it work
|
-turns off pit gonadotrophins so you dont have LSH and FH dictating
-inhibits ovulation -thicken cervial mucous: sperm cant swim and get past cervix -alters endometrial lining: makes it impossible for implantation |
|
|
combined pill etc.
|
-7 types of progestins
-1 type of estrogen -monophasic (each pill has same quantitiy of hormone in it) vs. triphasic vs. extended cycling |
|
|
extended cycle pill: seasonale
|
-84 monophasic pills followed by 7 placebo pills for 3 mo cycle
-side effects: spotting |
|
|
extended cycling- lybrel
|
-365 active pills per year: no period at all
|
|
|
candidates for extended cycling
|
-menorrhagia
-dysmenorrhea -PMDD |
|
|
pt instructions for pill
|
-start on sunday
-use backup for 1 mon |
|
|
initial exam
|
-level of develop
-neurological deficits -breats exam/pelvic exam/Pap -cardiovascular: murmurs, arrhythmias, bruits, BP (evaluate this on follow-up - 1% get high BP) -peripheral vascular |
|
|
who should not be on combined OCs
|
1. HTN
2. epilepsy 3. gallbladder disease 4. smoker >35 5. venous insufficiency 6. DVT 7. coagulopathy 8. DM with vascual complications 9. CVA 10. migraines 11. dyslipidemia, liver disease, heart disease 12. undx vag bleeding 13. pt on certina meds: mostly neuro and psyc meds |
|
|
early pill danger signs
|
A: abdominal pain
C: chest pain H: headaches E: eye problems S: severe leg pain |
|
|
adverse effects of OCs
|
1. DVT: pulmonary embolism
2. blood dycrasias 3. venous thomboembolism risk 4. MI (especially if a smoker and on OCs)- no increased risk for women who are young, do not smoke and do not have HTN |
|
|
ortho evra patch
|
-weekly dosing increasing compliance
- highly effective 95% -less side effects -same health benefits as OCs -costly |
|
|
nuvaring
|
-1/month
-less side effects -low cost -same health benefits -can be removed up to 3 hrs |
|
|
progestin only pill
|
(mostly on breastfeeding moms on this pill)
-minipill- 28 active pills -ok for HTN and smokers -strict dosing schedule- cannot miss -irregular menses; spotting |
|
|
depo-provera- "The shot"
|
-dosing every 11-13 wks
-side effect: spotting, amenorrhea, weight gain, osteopenia, may exacerbate depression and decrease libido -consider for pts with: dysmenorrhea, endometriosis, PMDD -encourage Ca intake -99.7% effective |
|
|
implanon
|
-single 3cm progesterone rod
-subdermal implant in medial aspect of arm -5 yr -same side effects as depo provera |
|
|
breast feeding moms
|
-lactational amenorrhea: lasts up to 6 months, but only if mom exclusivley bottle feeds
-progestin only pill can be used -depo-provera injection -implanon -IUD |
|
|
tubal ligation
|
-permanent
-laparascopic -high percentage of pts regret this choice |
|
|
essure
|
-non surgical alternative for permanent sterilization
-coil put up with hysteroscope; place in fallopian tube and scar tissue forms around it -quick almost 100% effective |
|
|
IUD
|
-safe and highly effective
-long term up to 10 yrs -easily placed and reversed -$400/10 yrs -5% increase in menstrual flow -possible cramps for first 2 months -small risk of expulsion in first 2 months -small risk for ectopic preg |
|
|
IUS contraindications
|
1. active STD
2. Active PID 3. abnl pap with need for colposcopy 4. abnl vag bleeding 5. copper allergy 6. hx of uterine structural abnormalities 7. fibroid uterus 8. hx of menorrhagia 9. pt at high risk for stds 10. grand multiparity |
