4500 Class 12 reproductive Choices And Sexual health History Flashcards
P. 145
The 5 ps of sexual Hx
Partners
Practices
Protection
Past Hx of STO’s
Pregnancy prevention
What can be tramsmittednthrough receiving or performing oral sex on a penic
Syphilis, Herpes, HPV, Gonorrhea and Chlamydia
What can be transmitted through vag/vulva/genitals
Syphilis, herpes, hpv,
What STIs do we measure through blood work
Syph
HIV
Hep B & C
Can be transmitted skin to skin
Have manh strains. Some cause genital warts. Cancers
How to prevent?
HPV
Prevented through immunization
Prevented
What are MOST EFFECTIVE hormonal contraception
— IUD/IUS (Mirena/Kyleena/Jaydess)
— Implant (Nexplanon)
What are MID-RANGE EFFECTIVE hormonal contraceptive
— combined oral contraceptives/patch/ring
— injectable (projectin)
— projectin-only pill
MOST EFFECTIVE, NON HORMONAL contraception
Tubal ligation/occlusion
Vasectomy
Copper IUD
MID RANGE, NON HORMONAL contraceptive
Lactational Amenorrhea
LEAST EFFECTIVE NON HORMONAL Contraception
Condoms
Withdrawal
Fertility swareness
Acronym we use to assess potentiom complication with hormonal contraceptition
What does it stand for
A. C. H. E. S.
Abdominal pain (liver or gallbladdrr)
C — Chest pain/dyspnea
H — Headache
E — Eye problems
S — Severe leg pain/swelling
What hormonal contraception can be used for postpartum? Why
Progestin-only (POP) pill
It has no estrogen.
Less changes of coagulation because postpartum pts are in a hypercoagulable state.
It does doe interfere with milk production.
Contraindications of progestin-only pill (POP)
Breast cancer, AUB (abnormal uterine bleeding), liver disease
What is a risk fot Combined Oral Contraceptives (COC)
VTE
Contraindications of Combined Oral Contraceptives (COC)
Smoking & age ?35
HTN
VTE
Heart disease
CVA
Breast cancer Liver disease AUD
Migraines with aura
Diabetes (with complications)
Menses may stop completely, or reduce flow of menses
HORMONAL IUDS
Intrauterine contraception that gives a Often heavier menstrual flow and cramping
NON-HORMONAL IUD
What are the risks of untrauterine contraception
- Infection
- Rupture of the uterus
- Expulsion
MOA: It causes a local inflammatory effect which are harmful to soerm & ova and impedes implantation. Projestin thickens the cervical mucus & thins the endometrium
HORMONAL IUS
MOA: It causes inflammatory reaction, impairs dperm function and implantation
COPPER IUD
What is the most effectice Emergency Contraceptive
Copper IUD
What does Induced Abortion mean
It is the purposeful interruption of a pregnancy before 20 weeks of gestationgestation
It can only be done as a way of abortion up to 9 weeks gestation
MEDICAL ABORTION
What are two drugs we use for Medical Abortion
Mifepristone
Misoprostol
(abortion services) when does an Rh NEG women with a negative Coomb’s test require Rh immune globin
If more than 49 days since LMP
In clinic up to 16 weeks gestation
In hospital up to 19 weeks 6 days gestation
Surgical Abortion
What is the nurses’ role in abortion services
Hx, pre-op, lab tests, education, review of record for signed consent, IV; nursing care duting the procedure and post-op, d/c teaching; Rh immune globulin administration
Watch sor s/s of infection, endometritis(fever/chills)
What are side effects of misoprostol?
Nausea, vomiting, chills, diarrhea, headcache or dizziness
When is medical abortion contraindicated
Ectopic
Prescrnce of IUD/IUS
When do we suspect imcomplete abortion/retained products of conception (medical)
What to do?
When there is a heavy or prolonged bleeding and cramping OR failure to have expected bleeding
We would potentially require additional doses of medication (misoprostol) or surgical aspiratiom
When is it considered abnormal bleed?
2pads/hr for w hours
When there is a clot larger than a lemon
S/sx of infection after abortion
Fever greater than 38 degrees
Ourulent vaginal discharge
uterine tenderness (*it is not normal!)
When does pain/cramping brgin? What to do
2-4 hours after misoprostol is talen, NSAISs can be used
When should memses return after abortion?
4-6 weeks after Bortion!Q!
