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NUR514: Maternity Exam 1 > Before Contraception > Flashcards

Before Contraception Flashcards

1
Q

What BC methods have lower failure rates? List two examples

A

Those that don’t invite user error → LARCs & permanent sterilization

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2
Q

What are some types of hormonal BC?

A

Pills; patches; shots; rings; implants

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3
Q

List the advantages of using hormonal BC

A

No effect on fertility
Relieves PMS
Lighter periods
No impact on spontaneity
Can be used to treat PCOS
Reduces acne

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4
Q

List the disadvantages of using hormonal BC

A

Need a Rx
NOT effective against STIs
Side effects → Nausea; breast tenderness; mood swings; weight gain; H/A; irreg bleeding
Adverse reactions → BLOOD CLOTS

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5
Q

What type of hormonal BC can cause irregular bleeding?

A

Progesterone methods

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6
Q

What patients are hormonal BC methods contraindicated for?

A

Migraine w/ aura
HTN
Hx of DVT; PE
Stroke
Smokers > 35 yrs

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7
Q

Test review: What contraception method is NOT a good option for smokers > 35 yrs?

A

Oral contraceptions

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8
Q

What type of oral hormonal contraceptive has placebo pills?

A

Combined → progestin & estrogen

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9
Q

Combined oral contraceptives are not a great method for

A

People who forget to take their pills every day

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10
Q

What type of oral contraceptive is safe for breastfeeding mothers?

A

Progestin only pills (POP)

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11
Q

What type of oral contraceptive has no placebo pills & what is the effective window?

A

POPs → must be taken within 3 hr window everyday to be effective

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12
Q

What can happen if pregnancy occurs in someone taking POPs?

A

Pregnancy is more likely to be ectopic due to slowing of cilia in fallopian tubes in response to progestin

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13
Q

Contraceptive ring (Nuva ring; Annovera)

A

Flexible silicone rings impregnated w/ estrogen & progestin

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14
Q

How long does a contraceptive ring stay in place for?

A

3 weeks → then removes for a week to create a withdrawal bleed & replaces w/ new ring

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15
Q

When can a contraceptive ring be removed & for how long?

A

Can be removed for intercourse & left out for up to 3 hrs per day

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16
Q

Contraceptive rings are not a great BC method for ?

A

Women who don’t like touching their bodies

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17
Q

Contraceptive patch (Twirla, Orth-vera)

A

Patch containing estrogen & progestin applied weekly for 3 weeks; followed by patch free week to create withdrawal bleed

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18
Q

Where should contraceptive patch be applied?

A

Upper back; upper arm; upper buttocks; or lower abdomen

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19
Q

Contraceptive patch should not be used in?

A

Patients with BMI > 30
Breast feeding mothers

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20
Q

Contraceptive injection (depo-provera)

A

Progestin only injection given every 13 weeks until pregnancy is desired

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21
Q

When should a woman start Depo-provera injections?

A

Within 7 days of the start of her last menstrual cycle

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22
Q

What happens to breastfeeding women getting depo injection?

A

It can diminish milk production

23
Q

Contraceptive implant (LARC → nexplanon)

A

4 cm rod of non-estrogen etonogestrel inserted under skin of inner arm

24
Q

How long is a contraceptive implants use for?

A

3 yrs (3-5 yrs)

25
What is an advantage of using contraceptive implant?
NO user error! → failure rate < 0.05%
26
What is a common side effect of contraceptive implants?
Unscheduled bleeding
27
List two types of emergency contraception
Levonorgestrel (plan B) Ulipristal (ella)
28
Levonorgestrel (plan B)
OTC or Rx → most effective when taken within 12 hrs of unprotected intercourse Does not affect existing pregnancy **Prevents ovulation** **Must be used within 72 hrs of unprotected sex** **More effective for BMI < 26**
29
Ulipristal (ella)
Rx only May be used within 120 hrs of unprotected sex Works as progestin blocker & may affect existing pregnancy **Works best for BMI < 35**
30
Intrauterine devices (IUDs) LARCs with & without hormones
Mirena & skyla → progestin-releasing Copper (paragard) → no hormones
31
Mirena IUD is more appropriate for ...
Women who have had children
32
Skyla IUD is more appropriate for ...
Women who have not had children
33
How do IUDs work?
Thinning the lining of the uterus & creating an environment that is not good for sperm **Hormone-releasing IUDs → prevent ovulation**
34
Advantages of Hormonal/ non-hormonal IUDs
No chance of user error Long acting: → Skyla - 3 yrs → Mirena - 5 yrs-7 yrs → Paragard - 10 yrs
35
Disadvantages of hormonal/ non-hormonal IUDs
Initially expensive Must be inserted by provider Paragard → heavier bleeding & cramping Mirena & skyla → amenorrhea Screening for STIs w/ placement Small risk of perforating uterus during insertion
36
List examples of barrier methods
Male condoms Female condoms Diaphragms Caps Sponges
37
What is an advantage to using male or female condoms?
Effective against STIs
38
Do diaphragms protect against STIs?
No
39
What are the guidelines for using Diaphragms?
Replaced every 2 yrs Should NOT be used w/ petroleum jelly → Used with spermicide No effect on women who breastfeed Fit should be checked if woman gives birth, has a miscarriage/ abortion, or gains/ loses > 10 lbs
40
Contraceptive sponges: How & when to insert?
Prior → woman wets sponge & inserts with fingers into top of vagina Sponge may be placed up to 24 hrs before sex → stay no more than 30 hrs
41
List two types of surgical contraception methods
Vasectomy Tubal ligation
42
Tubal ligation (females)
Risks → bleeding, infection Regrets → informed consent needs to emphasize permanence If pregnancy occurs → more likely ectopic
43
Vasectomy (males)
**Cutting vas deferens prevents sperm from exiting body** Effects → mild pain & swelling F/u with sperm count & use alternate BC until cleared No impact on sexual function Reversal → possible but $$$
44
Contraception method for STIs: Ex. Patient diagnosed with HIV
They need really effective BC → combo of barrier method & LARC **to prevent spread of HIV & ↓ user error to prevent pregnancy**
45
Candidates for genetic counseling
1. Moms > 35 yrs at time of delivery 2. Ethnic → Ashkenazi Jews; Tay Sachs 3. Recurrent pregnancy loss 4. Family Hx of genetic disorders/ birth defects 5. Personal Hx of genetic disorder 6. Children w/ genetic disorder
46
List the genetic testing options
Amniocentesis Chorionic Villus Sampling (CVS) Nips Testing
47
Amniocentesis
~ 15-20 weeks **Sample of amniotic fluid & test fetal DNA for diff chromosomes** Miscarriage risk < 1% Small risk of post amnion ROM
48
Chorionic Villus Sampling (CVS)
~ 10-12 weeks **Tissue from chorion (baby's) side of the placenta is tested** **EARLIER than AMNIO** Miscarriage ~ 1% Can be done as early as 8 weeks **Analyzes for chromosome analysis**
49
With CVS & amniocentesis what should be instructed to the patient?
Report ANY bleeding or cramping NOT drive themselves home
50
Non-invasive prenatal screening (NIPS)
Tests maternal serum blood **Anytime from ~ 8-10 weeks until end of pregnancy** Only tests for trisomy 13, 18, & 21 **Can see gender but NOT as conclusive as CVS or amnio**
51
What genetic testing is considered an incorrect distractor?
23 & me
52
What is a common misconception of LARCs?
That they cause infertility → they do NOT
53
When should infertility evaluation be initiated?
Lack of pregnancy: → After 12 mos for women < 35 yrs → 6 months for women > 35 yrs
54
Who should receive preconception care?
Advanced maternal age Chronic conditions → DM, HTN Lifestyle factors → smokers; alcoholics; drug users Patients prescribed meds that can be teratogenic **Anyone who has a habit that needs to change once pregnant**

NUR514: Maternity Exam 1 (6 decks)

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