Contraceptives Nursing Program Exam 2 210

Front 1

Offer teaching about contraception during?

Back 1

During any contact with a woman.

Front 2

Provide privacy for the discussion.

Back 2

Considerations when teaching about contraception.

Front 3

When discussing contractiption, include the womans?

Back 3

Partner if she wishes.

Front 4

The avoidance of sexual intercourse or any activity which would allow sperm to enter the vagina is the only completely effective method of preventing pregnancy and sexually transmitted diseases (STD's)?

Back 4

Abstinence

Front 5

No drugs, no hormones, no devices, free, no side effects?

Back 5

Advantages of abstinence

Front 6

Requires perfection in use, often difficult to achieve. If not used adequately, pregnancy rates are as high as 85%?

Back 6

Disadvantages of abstinence

Front 7

Some contraceptive method should be used by?

Back 7

6 months or before the time that a mother is using supplementary feedings or after first menses.

Front 8

Inhibits ovulation but is a less reliable method of contraception because many things can alter hormone production. Another contraceptive method should be used by 6 months or before that time if the mother uses supplementary feedings or resumes her menses?

Back 8

Breastfeeding

Front 9

No drugs, no hormones, no side effects, free?

Back 9

Advantages of breastfeeding

Front 10

Infants must be totally breast fed, breastfeeding must continue day and night, ovulation can occur without the womans knowledge?

Back 10

Disadvantages of breastfeeding

Front 11

Do not give solids or formula or skip feedings if using breastfeeding as a contraception because?

Back 11

Ovulation will occur

Front 12

A silicone cap that fits over the cervix to prevent sperm from entering. Spermicide is applied to both sides of the cap?

Back 12

Cervical cap

Front 13

Avoids systematic hormones, may fit women who are unable to use a diaphragm, has a loop to make insertion and removal easier, no need to add spermicide for repeated intercourse, no pressure against the bladder, less noticeable, can remain in place for 48 hours?

Back 13

Advantages of a cervical cap

Front 14

Women with abnormalities may not be able to use, must be fitted by a provider, possible toxic shock syndrome, cheap, must be comfortable touching herself?

Back 14

Disadvantages of a cervical cap

Front 15

Insert ahead of time for spontinaety, add spermicide for repeated episodes, check placement before and after for placement, do not use during menses, replace after 2 years or after pregnancy?

Back 15

Teachings for use of cervical cap

Front 16

Withdrawal is the remove of the penis from the vagina before ejaculation.

Back 16

Coitus interruptus

Front 17

No drugs, no hormones, no devices, no side effects, free?

Back 17

Advantages of Coitus Interruptus

Front 18

Pregnancy rate is 27%, requires great control, may cause dissatisfaction for both?

Back 18

Disadvantages of Coitus Interruptus

Front 19

Not a reliable method of contracetption?

Back 19

Teaching for Coitus Interruptus

Front 20

A polyurethane sheath inserted into the vagina with a flexible ring at each end. One ring fits over the cervix like a diaphragm and the other ring extends outside the vagina to partially cover the perineum?

Back 20

Female condom

Front 21

Female protection from STD without relying on a man, avoids hormones, easy to get, easy to carry, inexpensive?

Back 21

Advantages of a Female Condom

Front 22

Less effective than the male version, pregnancy rate of 21%, many women object to it on esthetic grounds, has a single use only, she must be comfortable touching herself?

Back 22

Disadvantages of a Female Condom

Front 23

Hold the outer ring in place during insertion and removal of the penis, do not use with a male condom as they may adhere to each other?

Back 23

Teaching for Female Condom

Front 24

Covers the penis during intercourse, preventing sperm from entering the vagina. Latex condoms provide the best protection available (other than abstinence from STDs. Natural membrane condoms are less effective against STDs. Polyurethane condoms can be used by people allergic to latex?

Back 24

Male Condom

Front 25

Readily available without a prescription, cheap, man or woman can carry them, good protection against STDs, avoids hormones, pregnancy rate of 15%?

Back 25

Advantages of Male Condom

Front 26

Interfere with spontanaety, may interfere with sensation, allergies, can be affected by medications in the vagina, may break or slip off, one use only?

Back 26

Disadvatages of Male Condom

Front 27

Used to prevent STD even with other contraceptives, use water based lubricant to help prevent breakage, check ESP dates, use lubricants to increase comfort, do not use oil base lubricants because they breakdown the latex, apply before any type of contact, squeeze the air out of the tip, leave a half inch of space at the tip, withdraw before softening occurs, change with each episode?

Back 27

Teaching for Male Condom use

Front 28

A latex dome surrounded by a spring or coil that is inserted over the cervix. It prevents passafe of sperm while holding spermicide in place?

Back 28

Diaphragm

Front 29

No hormones, failure rate 16%, may be inserted ahead of time to decrease spontenaety?

Back 29

Advantages of Diaphragm

Front 30

Pressure on the urethra causing UTIs, uncomfortable, allergies to latex, toxic shock, must be placed by a provider, expensive, requires a lot of education, difficult to insert or remove, she must be comfortable touching herself?

Back 30

Disadvantages of Diaphragm

Front 31

Inspect for small holes, use spermicide in the dome and around the rim, empty bladder before use, insert while squatting or placing one foot on a chair, be sure the front rim fits behind the pubic bone, cervix should be felt through the center of the diaphragm, use more spermicide if repeated use within 6 hour time frame, leave it in place for 6 hours after, no more than 24 hours after, replace every two years?

Back 31

Teaching for Diaphragm

Front 32

Is used to prevent pregnancy after unprotected intercourse. The woman takes two tablets containing a large dose of progestin (Plan B) or a larger-than-usual dose of combined oral contraceptives (OCs). Action is to prevent or delay ovulation, thicken cervical mucus, and alter sperm transport. It is ineffective if implantation has occurred and will not harm a developing fetus. A copper T 380A intrauterine device may also be used for emergency and continuing contraception?

Back 32

Emergency Contraception (Morning After pill)

Front 33

May be used for contraceptive failure, rape, or incorrect or lack of contraceptive use, reduces the risk of pregnancy by 75% (combined OCs) to 89% (Plan B) to 99% (IUD)?

Back 33

Advantages of Emergency Contraception (Morning After pill)

Front 34

Side effects include nausea and vomiting, especially with combined OCs?

Back 34

Disadvantages of Emergency Contraception (Morning After pill)

Front 35

Take as soon as possible after unprotected intercourse. It works best if taken within 72 hours but it may be taken as long as 120 hours after intercourse, take together or 12 hours apart, antiemetics may be given for nausea, some providers give women prescriptions to have on hand in case of need, may be obtained from pharmacists in some areas, further information available at 1-888-NOT-2-LATE or www.not-2-late.com?

Back 35

Teaching for Emergency Contraception (Morning After pill)

Front 36

Is no longer available in the United States. A new single rod progestin implant (Implanon) is expected to be approved shortly. The implant will provide contraception for 3 years?

Back 36

Hormone Implant

Front 37

Inserted into the uterus to provide continuous pregnancy prevention. Two types are available in the United States.

Back 37

Intrauterine Devices

Front 38

Copper T 380A, has a copper wire on the device, effective for 10 years, pregnancy rate: 0.8%?

Back 38

ParaGard

Front 39

Levonorgestrel intrauterine system, releases progestin contnuously, effective for 5 years, pregnancy rate of 0.1%?

Back 39

Mirena

Front 40

Safe for use during lactation, low long-term cost, in place at all times to provide continuous contraception, unrelated to coitus, often inserted at 6-week postpartum visit?

Back 40

Advantages of Intrauterine devices

Front 41

Expensive at the time of insertion, should be used only by women in mutually monogamous relationships and at low risk for STDs?

Back 41

Disadvantages of Intrauterine Devices

Front 42

Infection may occur with insertion or during the first few weeks. Then the risk of infection is low in women with low risk for STDs
Expulsion
Perforation of uterus at the time of insertion
If pregnancy occurs, may have ectopic pregnancy, spontaneous abortion, or preterm delivery?

Back 42

Complications of Intrauterine Devices

Front 43

Nulliparous women
Recurrent pelvic infections
History of ectopic pregnancy
Bleeding disorders
Uterine abnormalities?

Back 43

Contraindications of Intrauterine Devices

Front 44

Side effects include cramping and bleeding with insertion, irregular periods and spotting followed by amenorrhea (Mirena), Menorrhagia (increased bleeding during menustruation), Dysmenorrhea (painful mentruation)
Use ibuprofen for cramping
Check for the plastic strings weekly during the first 4 weeks, then monthly after menses, and if signs of expulsion (cramping or unexpected bleeding) occur.
Use only if in a mutually monogamous relationship and with a low risk for STDs.
See a health care provider if signs of infection occur
Reprot signs of pregnancy to rule out ectopic pregnancy and remove the IUD.
Schedule a yearly Pap smear
Get checked for anemia if menses are heavy. May need to take iron?

Back 44

Teaching for Intrauterine Devices

Front 45

Depo-Provera (medroxyprogesterone acetate, or DMPA) is an injectable progestin that is given by deep intramuscular injection. The site should not be massaged after injection, as this accelerates absorption. The injection should be given with 5 days of the beginning of the menstrual period?

Back 45

Hormone Injections

Front 46

Prevents ovulation for 12 weeks
Only four doses a year are needed
Pregnancy rate of 3%
Convenient
No estrogen
Unrelated to coitus
May cause amenorrhea?

Back 46

Advantages of Hormone Injections

Front 47

Must be repeated on time to keep up effectiveness
Should not be used by women with contraindications for othe hormone contraceptives
Delay in return of fertility may be 10 to 18 months after discontinuation
No protection from STDs
Menstrual irregularities may cause discontinuation
Should not be used in adolescents; other women should not use for more than 2 years?

Back 47

Disadvantages of Hormone Injections

Front 48

Menstual irregularties: spotting, breakthrough bleeding
Amenorrhea in 30% to 50% of women at 1 year
Decrease in bone density
Weight gain: approximately 1.8kg (4lb/year) for some women
Headaches
Decreased libido
Nervousness
Breast discomfort
Depression?

Back 48

Side effects for Hormone Injections - Teaching

Front 49

If received after the first 5 days of the menstural cycle, use another contraceptive for the first week.
Usually not started until 6 weeks after delivery for breastfeeding women.Return for injections every 12 weeks.
Take calcium and vitamin D and get adequate exercise to decrease bone density loss?

Back 49

Teaching for Hormone Injections

Front 50

This slicone device fits over the cervix like a diaphragm or cap. It is used with spermicide?

Back 50

Lea's Shield

Front 51

Avoids systemic hormones
A loop aids in removal?

Back 51

Advantages of Lea's Shield

Front 52

Requres a prescription
Possibility of toxic shock syndrome
Must be comfortable touching the genitalia?

Back 52

Disadvantages of Lea's Shield

Front 53

Insert ahead of time to decrease interference with spontaneity
Do not remove for 8 hours after last intercourse.
Remove within 24 hours.
Add spermicide for repeated intercourse.
Feel around the cervix to check placement before intercourse?

Back 53

Teaching for Lea's Shield

Front 54

Based on predicting ovulation by physiologic changes and avoiding coitus or using another contraceptive method when the woman is fertile. They also may be used to help women become pregnant?

Back 54

Natural Family Planning Methods. Also called fertility awareness or periodic abstinence methods.

Front 55

Acceptable to most religions
Help women learn about normal body changes
Avoid the use of drugs, chemicals, and devices
Pregnancy rate 2% to 5% if used perfectly.

Back 55

Advantages Natural Family Planning Methods

Front 56

Couples must be highly motivated
Couples must avoid intercourse for as much as half the mestrual cycle
Extensive education required
Typical use pregnancy rate of 25%
Very unforgiving method; errors likely to result in pregnancy
No protection agains STDs?

Back 56

Disadvantages of Natural Family Planning Methods

Front 57

Mus be specific to the individual method.
Method may be used to determine fertile period and another contraceptive method can be used at that time.

Back 57

Teaching of Natural Family Planning Methods

Front 58

Contain estrogen and progestin or progestin alone. Combination contraceptives cause cervical mucus to become too thick for sperm to penetrate, inhibit ovulation, impair sperm capacitation, slow tubal motility, and make the endometrium less hopitable to implantation. Progestin-only oral contraceptives are useful for women wo must avoid estrogen, but they are less effective at inhibiting ovulation?

Back 58

Oral Contraceptives

Front 59

Pregnancy rate of 8%
Can be used by healthy women who do not smoke until menopause
Unrelated to coitus
Reduce ovarian and endometrial cancer
Regulate mentrual cycles and reduce blood loss
Decrease incidence of benign breast disease, ovarian cysts, pelvic inflammatory disease, ectopic pregnancy
Improve acne, premenstrual symptoms, dymenorrhea, and other conditions?

Back 59

Advantages of Oral Contraceptives

Front 60

No protection against STDs
Must be taken daily near the same time of day
Return of fertility may take 3 to 6 months after discontinuation
Increases incidence of some conditions?

Back 60

Disadvantages of Oral Contaceptives

Front 61

Should not be used by women with a history of:
Thrombophlebitis or thromboembolic disorders
Cerebrovascular or cardiovascular diseasesAny estrogen-dependent cancer or breast cancer
Benign or malignant liver tumors
Hypertension
Migraines with focal aura
Diabetes with vascular involvement or of more than 10 years' duration?

Back 61

Part of the teaching for Oral Contraceptives

Front 62

Should not be used by women who currently have:
Impaired liver function
Suspected or known pregnancy
Undiagnosed vaginal bleeding
Heavy cigarette smoking (more than 15/day in women older than 35; any smoking over age 40. Any use of cigarettes is discouraged and should be evaluated individually)
Major surgery requiring prolonged immobilization?

Back 62

Part of the teaching for Oral Contraceptives

Front 63

Nausea
Headaches
Breast tenderness
Breakthrough bleeding
Weight gain or loss
Fluid retention
Amenorrhea
Mood swings
Melasma?

Back 63

Side effects of Oral Contraceptives

Front 64

Maintain hormone levels by taking the pills at the same time each day
Use another conraceptive method during the first week of the first cycle unless the pills are begun on the first day of menses
Side effects often decrease afer the first few months of use. Changing the dose of estrogen or progestin may help.?

Back 64

Part of the teaching for Oral Contraceptives

Front 65

Progestin-only contraceptives do not affect mild production and are more appropriate during lactation than combination OCs. They are often started at 6 weeks postpartum.
Inform the health care provider of all medications being used. OC interaction with other drugs may decrease effectiveness of both (e.g., some anticonvulsant, anti-tuberculosis, and antifungal drugs, St John's wort, some antiviral drugs). Antibiotics such as ampicillin or tetracycline do not affect effectiveness.
Obtain a yearly breast examination and blood pressure measurement. Papanicolaou test recommendations are the same as for other women.?

Back 65

Part of the teaching for Oral Contraceptives

Front 66

What does the A stand for in the acronym ACHES to aid in remebering signs that should be reported immediately in Oral Contraception use.

Back 66

Abdominal pain (severe)

Front 67

What does the C stand for in the acronym ACHES to aid in remebering signs that should be reported immediately in Oral Contraception use.

Back 67

Chest pain, dyspnea, hemoptysis

Front 68

What does the H stand for in the acronym ACHES to aid in remebering signs that should be reported immediately in Oral Contraception use.

Back 68

Headache (severe), weakness or numbness of extremities, hypertension

Front 69

What does the E stand for in the acronym ACHES to aid in remebering signs that should be reported immediately in Oral Contraception use.

Back 69

Eye problems: visual changes such as blurred or double vision or visual loss, speech disturbance

Front 70

What does the S stand for in the acronym ACHES to aid in remebering signs that should be reported immediately in Oral Contraception use.

Back 70

Severe leg pain or swelling (calf or thigh)

Front 71

Applied to the skin once weekly for 3 weeks and left off during the fourth week, during which menses occurs. Releases small amounts of estrogen and progestin?

Back 71

Patch (Transdermal)

Front 72

Applied only once a week, so is easier to remember than pills
Unrelated to coitus
Regulates menstrual cycles
Pregnancy rate of 8%
Convenient

Back 72

Advantages of Patch (Transdermal)

Front 73

Requires a prescription
Must be applied on the right day
Less effective in women greater than 90kg (198lb)
May cause skin irritation
Side effects similar to oral contracteptives
Visible on the skin
Does not protect from STDs

Back 73

Disadvantages of Patch (Transdermal)

Front 74

Apply to clean dry skin on the abdomen, upper torso (except the breasts), buttock, or upper outer arm.
Avoid oil or lotion in the area.
Use a different site each week and apply on the same day of the week.
Wear continuously fo 7 days.
Begin a new cycle after the seventh day of the patch-free week.

Back 74

Teaching for Patch (Transdermal)

Front 75

Comes in many forms. Creams and gels are used with mechanical barriers such as the diaphragm or cervical cap. Foams, foaming tablets, suppositories, and vaginal film may be used alone. They are inserted into the vagina just before sexual intercourse and are effective for about 1 hour. Vaginal films and suppositories must melt, which takes approximately 15 minutes, before they become effective?

Back 75

Spermicides

Front 76

Readily available without a prescription
Inexpensive per use
Easy to use
Provide lubrication
Avoid use of systemic hormones?

Back 76

Advantages of Spermicides

Front 77

Should be used with condoms
Messy
Some feel they interfere with sensation
Pregnancy rate of 29% if used alone
No protection against STDs
May cause irritation
Must be comfortable touching the genitalia?

Back 77

Disadvantages of Spermicides

Front 78

Sensitivity may cause genital irritation, which may increase risk of infection.
Avoid douching for at least 6 hours after intercourse.
Add mor spermicide if coitus is repeated.

Back 78

Teaching for Spermicides

Front 79

Permanent and effective. It should be used only by those who understand that reversal surgery is difficult, expensive, not always seccessful, and may not be covered by insurance. Both female and male sterilization end concern about pregnancy but do not offer protection against STDs.

Back 79

Sterilization

Front 80

Involves cutting or mechanically occluding the fallopian tubes during a minilaparotomy, laparoscopy, or other abdominal surgery scush as cesarean birth. May also be performed nonsurgically by insertion of a coil through the cervix and into the fallopian tubes (Essure).

Back 80

Tubal Ligation

Front 81

Pregnancy rate of 0.5%
Can be performed with a cesarean birth
Convenient if performed during the immediate postpartum period, when the fundus is near the umbilicus and the fallopian tubes are directly below the abdominal wall
Can be performed at other times as outpatient surgery.

Back 81

Advantages of Tubal Ligation

Front 82

Most methods require surgery. Coil method requires a hysterosalpingogram at 3 months to ensure the tubes are blocked.
General enesthesia is most common for surger, but regional or local anesthesia may be used.
Initially expensive, but ends future contraception costs.

Back 82

Disadvantages of Tubal Ligation

Front 83

If tubal ligation is to be performed soon after childbirth, the consent forms must be signed well before labor.
Rest for 24 hours after surgery and do not lift heavy objects for a week.
Call the provider if there is fainting, severe pain, or incisional bleeding or discharge.

Back 83

Teaching for Tubal Ligation

Front 84

Involves cutting or cauterizing the vas deferencs through a small incision in the scrotum so that semen no longer carries sperm.

Back 84

Vasectomy

Front 85

Pregnancy rate of 0.15%
Can be performed in a physician's office under local anesthesia
Less expensive than tubal ligation

Back 85

Advantages of Vasectomy

Front 86

Requires surgery
Expensive at the time of the surgery, but less expensive than tubal ligation and ends future contractption costs
Requires another contraceptive method until the semen is fee of sperm

Back 86

Disadvantages of Vasectomy

Front 87

Rest, apply ice to the area, and use a scrotal support for 2 days.
Observe for excessive fever, severe pain, bleeding or discharge, a painful nodule, or swelling more than twice the nomal size.
Complete sterilization does not occur until no sperm are in the semen, which may be 3 months or more.
Semen specimens should be analyzed until two specimens show no sperm present.

Back 87

Teaching for Vasectomy

Front 88

A soft flexible ring inserted into the vagina and left in place for 3 weeks. It is removed for 1 week during which menses occurs. The ring releases small amounts of estrogen and progestin.

Back 88

Vaginal Ring

Front 89

Requres action only twice a month (insertion or removal)
Unrelated to coitus
Pregnancy rate of 8%
Convenient
No fitting required
Not visible to others
Less spotting than with other hormonal methods

Back 89

Advantages of Vaginal Ring

Front 90

Requires a prescription
Must remember when to insert and remove
Side effects: expulsion, vaginitis, vaginal discomfort and others similar to oral contraceptives
Must be comfortable touching the genitalia
Some women or their partners feel the ring but this is not usually a problem

Back 90

Disadvantages of Vaginal Ring

Front 91

Insert within the first 5 days of the menstrual cycle.
Use a backup method the first cycle unless a hormonal method was used the previous month.
May be removed up to 3 hours without loss of effectiveness. If longer, use a backup method for 7 days.

Back 91

Teaching for Vaginal Ring

Front 92

Hormone Delivery Methods

Combine estrogen and _________.

Back 92

progesterone

Front 93

Hormone Delivery Methods

Oral pills daily
21/__, 24/__, 84/__.

Back 93

7, 4, 7

Front 94

Hormone Delivery Methods

Patch 7-__ day?

Back 94

9

Front 95

Hormone Delivery Methods

IM injection _______.

Back 95

monthly

Front 96

Hormone Delivery Methods

Vaginal ring __+ week

Back 96

3

Front 97

Hormone Delivery Methods

Progestin-_____.

Back 97

only

Front 98

Hormone Delivery Methods

Minipill ______.

Back 98

daily

Front 99

Hormone Delivery Methods

IM/SQ injection every __ months.

Back 99

3

Front 100

Hormone Delivery Methods

IUD/IUS every 10, 1, or __+ year?

Back 100

5

Front 101

Hormone Delivery Methods

Implant subq 2-__ year

Back 101

5

Front 102

Must start within 72 hours, earlier is better
Combination Yuzpe regimen (Preven)
Progestin-only Plan B
Copper-T IUD
Antiprogesterone mifepristone (RU-486)

Back 102

Postcoital Emergency

Front 103

Spacing Pregnancies >2yr

Periodic abstain, including:
Standard Days Method
calendar rhythm
Basal Body Temp
cervical mucus
symptothermal
ovulationLH surge

Back 103

Fertility awareness

Front 104

Spacing Pregnancies >2yr

<6 months
Amenorrheic
fully breastfeeding

Back 104

Lactational LAM

Front 105

Spacing Pregnancies >2yr

Interruptus/withdrawal
douching

Back 105

Situational

Front 106

Chemical or Mechanical

Spermicides

Back 106

Chemical