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168 Cards in this Set

  • Front
  • Back
decisions an individual or a couple makes about having children
family planning definition.
The ideal contraceptive:
100% effective
free of side effects
easily attainable
acceptable to couple
no effect on future partners
Family planning: Assess client using ________ ____ _____ assessment
reproductive life planning assessment
When teaching about family planning, teach the client the ______, ______ and ______ of each method
side effects.
2 methods of family planning:
contraceptive device
really try to encourage abstinence with:
2 advantages with abstinence:
most effective way to avoid conception and STDs
2 disadvantages with abstinence:
-difficult to comply
-confidence to say NO
in the united staes, there are __-__x more teenage pregnancies then in western countries
Measures to empower client during abstinence:
Discuss with client:
what sexual activity is permissible
Measures to empower client during abstinence:
Help client recognize and avoid:
high risk situations
Measures to empower client during abstinence:
If Pressured, teach to:
say NO as if they really meant it
Measures to empower client during abstinence: Be sure that partner understands that you consider being forced into relations against your wishes as:
the same as rape
Contraceptive devices can either be classified as: (2)
there are two types of hormonal oral contraceptives:
combination pill
The combination pill contains ____________which prevents ovulation.
estrogen and progestin
the combination pill causes thinning of ___________ to prevent implantation
Combination pill: What is the failure rate with perfect use?
0.1% (1 in 1000)
Benefits of the combination pill:

1. Failure rate with perfect use is_____%
2. Prevents _______ and ______ CA
3. regulates ____________
4. reduces ______ ____ and ____ ____
5. prevents _______ ____ ____ and ____ ___
1. 0.1%
2. ovarian/endometrial
3. menstrual cycle
4. premenstrual pain/blood loss
5. fibrocystic breast disease and ovarian cysts
When was the combination pill developed?
in the 1950s
The combination pill may decrease risks of (3)
How often do you need to get a physical if on combination pill? What needs to be assessed?
q year

What are some of the disadvantages/ SE's of the combination pill?
wt gain
brest tenderness
increased monilial infections
increased risk for bld clots
increased risk for htn
With the combination pill, you are at a ___-___x greater risk for htn then non user
when taken off combination pill, Blood pressure may
go down
You should discontinue use of combination pill how long before surgery?
Contraindications for taking the combination pill include:

1._________(risk for decreased milk)
2.hx __________ ______ (esp over 35 and smoking)
3. family hx of ___ or ___
4. hx _____ ___
5. hx ____/_____
1. lactation
2. thromboembolic disease
4. breast cancer
5. increased bp/htn
Medications which interfere with effectiveness of combination pill:
(spit dart brag)
-st johns wart, penicillin
-isoniazide, tetracycline
-dilantin, ampicillin
-rifampine, tylenol
-barbituates, ritonivire (HIV)
-anticoagulants, guanethidine
Extended cycle oral contraception is another type of combination pill. what is an example of one?
Seasonal is ____% effective
how many periods a year does a woman on Seasonal have?
what are the benefits and risks of Seasonal?
same as for other combination pills
Seasonal-__day regimen-___ active pills, ___ placebo
any pill with estrogen and progesterone together have
same complications
What is an ex. of a progestin only pill?
the minipill
minipill: perfect use failure rate: ____%
0.5% (5 in 1000)
efficacy of combination pill in overwt. women?
less effective
The minipill is slightly _____ effective than the combo pill.
does the minipill stop ovulation?
does the minipill interfere with breast feeding?
What does the minipill actually do?
-Thickens cervical mucous making it more difficult for sperm to enter.
-modifies endometrium making less favorable for implantation
The minipill is a good option for woman who suffer S/E's of
The minipill is the only safe option for:
women over 35 and smoking
Injection: Depo-Provera: perfect use faliure rate:
0.3% (3 in 1000)
Injection: Depo-Provera: does this stop ovulation?
Injection: Depo-Provera: is this injection IM or SC? how often do you need to get the injection?
q12 wks
If the depo provera shot is given IM, its for _______. If it is given SC, its for ______.
Injection: Depo-Provera: contains _________ which suppresses ovulation, thickens cervical mucous, and thins endometrium.
Injection: Depo-Provera: causes:
Injection: Depo-Provera: lowers chance for _____ and ___
endometrial and ovarian cancer
Injection: Depo-Provera: protects against _____ _____
ectopic pregnancy
Injection: Depo-Provera: can cause spotting for first ___-___months
Injection: Depo-Provera: with this injection it is sometimes difficult to stimulate ovulation again. It might take ____ yrs before woman can get pregnant.
Injection: Depo-Provera: with this injection, woman can lose how much bone density in 1 yrs time (although there is conflicting data regarding bone loss)
Injection: Depo-Provera: should not be using this BC for more then:
Injection: Depo-Provera: to help minimize bone loss, take ______mg of ___ with ___-___units of _____
1500 Ca
400-800 vit D
Injection: Depo-Provera: why should woman take calcium with vitamin d?
vit d helps abs. calcium
Injection: Depo-Provera: four annoying side effects:
wt gain
decreased libido
Lunelle: injection that women receives how often?
1x per month
Lunelle: perfect use failure rate:
Lunelle: Advantages: (2)
-more reg. bleeding pattern then depo
-fertility returns c in 3 months
Lunelle: Disadvantages: (3)
-breast tenderness/wt. gain
-req's monthly visits or self inj
The contraceptive Patch was approved by FDA the same year the Nuva ring was approved:
Contraceptive Patch: Evra: perfect use failure rate:
Contraceptive Patch: Evra: Transderm patch releases a steady dose of ___________.
estrogen and progestin
Contraceptive Patch: Evra: replaced once every seven days for 3 wks, not worn
fourth wk.
Contraceptive Patch: Evra: advantages:
-Lasts for 7 days, but is effective for
-small, easy to conceal, not likely:
-apply to: (5)
-to fall off
-chest, abd, upper arm, thigh, buttock
Contraceptive Patch: Evra: disadvantages: may not be completely effective for women over ____lbs (90kg)
Contraceptive Patch: Evra: skin rxns at site possible (___________)
dryness at patch site
Contraceptive Patch: Evra: Heat/increased skin temp increases ____________. This increases risks for _____.
absorption of med
Vaginal Ring: Nuva-ring: Perfect use failure rate: ____%
Vaginal Ring: Nuva-ring: soft siliconne ring releases a steady dose of __________. It is left in place for three weeks and is not worn fourth wk.
estrogen and progesterone
Vaginal Ring: Nuva-ring: Disadvantages: Numerous side effects. Same as combo pills plus:
-vag irritation/infection
-wt gain
Vaginal Ring: Nuva-ring: advantages:
1. lasts for ______
2. Client can_______
3. Effective for _______ if not removed
4. Precise _________
1. 3wks
2. insert and remove independently
3. 35
4. positioning is not critical
Single rod implant:
Implanon is inserted and removed by:
experienced professional
What hormone is in implanon?
progestin only
How does Implanon effect ovulation?
it inhibits ovulation
Implanon increases:
viscosity of cervical mucous
Implanon: Advantages: (3)
-fertility quickly returns
-can breast feed
-effective for 3 years!
Implanon: Disadvantages:
1. Disturbance of menstrual pattern (_______)
2. Occasional _______,_____, ______
3. must be____________ period
2.wt gain, mood changes, skin disorders
3. removed by experienced professional
IUD: Intrauterine system (IUS): perfect use failure rate:
IUD: Intrauterine system (IUS): ________: T shaped device is placed in uterus and releases a steady dose of __________. Thickens cervical mucous, inhibiting sperm migration. Reduces growth of ___________.
IUD: Intrauterine system (IUS): Mirena: Advantages:

Lasts for
5 years
IUD: Intrauterine system (IUS): Mirena: Advantages:

menstrual bld loss
IUD: Intrauterine system (IUS): Mirena: Advantages:

may have protective effect against
endometrial ca
IUD: Intrauterine system (IUS): Mirena: Advantages:

returns rapidly after removal
IUD: Intrauterine system (IUS): Mirena: Disadvantages:

may increase
IUD: Intrauterine system (IUS): Mirena: Disadvantages:

inserted and removed
by clinician
IUD: Intrauterine system (IUS): Mirena: Disadvantages:
some side effects: (3)
breast tenderness
IUD: Intrauterine system Progestasert: perfect use failure rate:
IUD: Intrauterine system Progestasert: very small T shaped device containing _______ is placed in the uterus. The ______ thickens cervical mucous inhibiting migration of sperm
IUD: Intrauterine system Progestasert: is an excellent choise for a women: (4)
with larger uterus
over 35
done with childbearing
IUD: Intrauterine system Progestasert: reduces ________ and _________
menstrual blding
IUD: Intrauterine system Progestasert: disadvantages:
must be replaced q year by health care provider
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Perfect use failure rate:
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: is a T shaped device placed in the uterus. If has a copper wire wrapped around the stem and arms which acts like a spermicide, preventing concepting. Creates:
inflammatory response/hostile implantation
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: advantages: lasts for
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Advantages: No:
hormone secretion
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: If this was removed, when would fertility return?
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Disadvantages: may increase:
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Disadvantages: must be:
inserted/removed by HCP
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Nursing concerns:
-Increased risk for _____ ______ or ______
ectopic pregnancy
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: this is contraindicated for clients with: (3)
-chronic disease
-valvular heart disease
-any type of implant
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Avoid this is you have never been pregnant because
uterus is small, possible perforation
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Even though fertility may return immediately, fertility may be decrease secondary to:
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Avoid this if client has multiple sex partners because
theres an increased risk for infection
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: Teach client to check after menses to :
insure string is in place
Contraceptive devices Non Hormonal methods (lack hormonal side effects):

Copper T380 IUD: is contained in ________. String hangs in ________.
Condom, Male. Perfect use failure rate:
Latex rubber or synthetic sheet placed over erect penis before coitus. Sperm are deposited in tip of condom during ejaculation.
Male Condom
Condom, Male: Advantages:
-No Rx
-male responsibilty
-prevents spread of STD's
-recommended for couples who aren't monogamous
-good for teens to prevent STDs and pregnancy.
Condom, Male: disadvantages: (2)
-allergy to latex
-sheep skin porous; risk for STD increased
Condom, Male: Nursing concerns:

1. Apply when:
2. Leave:
3. Withdraw:
1. penis is erect prior to ejaculation
2. loose area at tip for ejaculation
3.penis prior to flaccidity
Long thin sheath made of polyurethane inserted in vagina. Open ring on one end remains on the outside while another closed ring covers the cervix preventing semen from entering the uterus
Condom, Female.
Condom, Female: Advantages:
prevents STDS
female control
Condom, Female: disadvantages:
-one time use
-decrease sexual sensation for both partners
Condom, Female: 3 nursing concerns regarding this.
1. remove after ejaculation
2. don't use with male condom
3. takes practice to insert
foams, suppository, film, cream, or jelly that is applied high in the vagina prior to sex. Contains chemical that kills sperm. Blocks semen from entering the cervical canal
Spermicidal Products:
Spermicidal Products: Perfect use failure rate:
Spermicidal Products: advantages:
-available without Rx
Spermicidal Products: disadvantages:
-client may be allergic
-must be applied shortly before intercourse
Flexible rubber device shaped like a shallow cup. Spermicide is placed in the dome and around the edges. worn over cervix, acts as barrier to sperm.
Diaphragm: perfect use failure rate without spermacide:
Diaphragm: advantages: can be inserted how long before intercourse?
Diaphragm: advantages: lowers
risk of certain stds
Diaphragm: disadvantages: Causes increased number of ____ r/t pressure on urethra
Diaphragm: disadvantages: cannot be used if woman has:
prolapsed, retroflexed or anteflexed cervix
Diaphragm: Avoid using the diaphragm if you have/had any of the following: (6)
-acute cervicitis
-hx toxic shock
-hx UTI
-allergic to rubber/spermicide
-hx cervical ca
-undiagnosed blding
Diaphragm: Nursing Concerns:

Must be fitted:
by HCP
Diaphragm: Nursing Concerns:

Return for new fitting after: _____,_____,_____, _____ or gain/loss of 15lbs
cervical surgery (D&C)
Diaphragm: Nursing Concerns: can be left in place ___-___hrs post coitus
Diaphragm: Nursing Concerns: teach to wash with:
mild soap, h2o

dry and store
Diaphragm: Nursing Concerns: the diaphragm lasts for
Smaller in size than diaphragm. Fits over cervix and held in place by suction.
Cervical Cap
Cervical Cap: perfect use failure rate for women who have never had child: ___%.

Perfect use failure rate for women who have 1 or more children: ___%
Cervical Cap: Advantages:
Can be left in place
for 24h
Cervical Cap: Advantages: lowers risk of
contracting certain STDs
Cervical Cap: Advantages: client must be fit by
Cervical Cap: Advantages: no pressure on urethra so
no UTI's
Cervical Cap: disadvantages: cannot use with _____ or _____ cervix
Cervical Cap: disadvantages: do not use with abnormal
pap smear
Cervical Cap: disadvantages: do not use if hx of:
Toxic shock syndrome
cervical ca
undiagnosed blding
Charting of menstrual patterns, basal body T, and changes in Cerv. mucous (and occasionally using reagent strips to determine luteinizing hormone level) to determine fertile days and avoid intercourse
natural family planning:
natural family planning: perfect use failure rate:
Natural Family planning: Advantages:

1. _______. No mechanical or hormonal intervention
2. more effective than _____ ____ is done correctly
barrier method
Natural Family planning: disadvantages:
1. difficult to use effectively if _______ ______
2. Daily _______ and _______ req.
3. abstain from intercourse at peak of ______ in menstrual cycle
1. irregular periods
2. testing/record keepingz
3. libido
pregnancy prevention methods initiated after unprotected sexual intercourse.
Emergency contraception
Emergency contraception: There are ___ hormonal methods and ___ nonhormonal method available in the US.
Emergency contraception: the three hormonal methods include:

1. a regime of high dose _____ ____ ______
2. a regime of ______ ____ pills
3. a dedicated emergency contraceptive product. Ex's _____ or ______
1. combination oral contraceptives
2. progestin only
3. preven/plan B
Emergency contraception: What is the nonhormonal method?
insertion of copper T380 up to 5 days post intercourse
Emergency contraception: history: first used in the ____'s to prevent pregnancy after unprotected sex.
Emergency contraception: Finally in ______ the FDA announced that it was safe and effective and encouraged manufacturers to market the products.
Emergency contraception: In ______ the FDA approved Preven, the first dedicated emergency contraceptive product.
First dedicated emergency contraception kit.
Emergency contraception: what is the cost of preven?
Emergency contraception: Preven is ___ high dose combo pills (Estrogen + Progesterone)
Emergency contraception: Preven: inhibits or delays ovulation by disturbing normal development of ________, and inhibiting _______
Emergency contraception: Preven: alters _____transport of ova and sperm
Emergency contraception: Preven: thickens ____, trapping sperm
cervical mucous
Emergency contraception: Norestrogen option (Plan B): FDA approved plan B in _____
Emergency contraception: Norestrogen option (Plan B): _______only pill developed to prevent pregnancy after unwanted sex.
Emergency contraception: Nonhormonal method (insertion of copper T380 within 5 days of unprotected intercourse): interferes with _______ and ________
Emergency contraception: Nonhormonal method (insertion of copper T380 within 5 days of unprotected intercourse): remove after __________ or keep in place for up to 10 years for contraception.
next menstrual period
Emergency contraception: Contraindications:
Emergency contraception: When to consider emergency contraception:

1. No contraception used _____ ______.
2. Male/Female condom _____, ______, or ______
3. Diaphragm/cervical cap ________, ______ or ______
4. IUD ________________
5. Possible ______ exposure has occurred
6. ______
7. 1 or more ____-only OC pills missed
8. __ or more of first 7 OC pills skipped or 4 or more during week 2 skipped.
1. during intercourse
2. slipped, broke, leaked
3.inserted incorrectly
4. partially/totally expelled
5. teratogen
6. rape
7. progestin
8. 2
Emergency contraception: Side effects:
breast tenderness
period may be early/late
flow may be lighter/heavier
Emergency contraception: Side effects: minimize n/v by
taking antiemetic one hour before first pill and continue dosing for 24 hours