Ch. 5 - Contraception Flashcards
Defined: Intentional prevention of pregnancy
Birth control is the device or practice to decrease the risk of conceiving
Family planning is the conscious decision on when to conceive or avoid pregnancy
May still be at risk for pregnancy
Nearly half of all U.S. pregnancies are unplanned despite best efforts
Nurses provide info on how provide contraceptive method, when use back-up, when use emergency
A multidisciplinary approach to assist the woman in choosing an appropriate contraceptive method
Ideally the method should be safe, readily available, economical, acceptable, and simple to use
Contraceptive choice must meet personal, social, cultural, and interpersonal needs
Contraception
Should be safe, effective, economical, acceptable, easily available, simple to use, and promptly reversible; no method may ever achieve these objectives fully and adv made; not one single is 100% - margin error always
Coitus interruptus (withdrawal)
Fertility awareness methods (FAMs)
Barrier methods
Hormonal methods
Emergency contraception (EC)
Intrauterine devices (IUDs)
Sterilization
Sterilization reversal
Methods of contraception
Pulling out
Not most effective way
High failure riate
Coitus interruptus (withdrawal)
Variety kinds
Rely on avoidance of intercourse during fertile periods
FAMs combine charting menstrual cycle with abstinence or other contraceptive methods
Identifying beginning and end of menstrual cycle; not know when is for them; good because low to very little cost - no chems/hormones; have to be very compliant for it to work; strict record keeping; unintentional interference that may alter vaginal secretions/core body temp - lot variables to work with
Do not protect against STIs
High failure in first year - often used to try to conceive than avoid pregnancy
Fertility awareness methods (FAMs)
Those who use barrier methods should be educated on emergency contraception options in the event of barrier failure because can happen; against protection of STIs; not 100% prevention pregnancy
Spermicides
Condoms, male (STI protection)
Vaginal sheath (STI protection)
Diaphragm
Cervical cap
Contraceptive sponge
Barrier methods
Reduce mobility of sperm
Effectiveness depends on consistent and accurate use
High failure rate
Frequent use of N-9 or the use of N-9 during anal intercourse may increase HIV transmission and lesions
Spermicides
Non-spermicidal latex condoms provide barrier against STIs and HIV transmission
Polyurethane= thinner & stronger
Latex perfect use better to prevent pregnancy - condom has N-9 on it not protect from STIs or HIV; non-spermicidal best protection from STIs/HIV
Natural skin condoms not best protection against STIs and HIV because porous
Condoms, male (STI protection)
Female condom
Can be noisy
Cannot use concurrently with male condoms
Vaginal sheath (STI protection)
Shallow dome with flexible rim and place spermicide and place inside against cervix - up to 6 hours to destroy sperm
Diaphragm - chem barrier to prengnacy
Mechanical (device shape)and chemical barrier (holds spermicide against cervix)
Poor choice for those with poor vaginal muscle tone - pelvic floor issues
Toxic shock syndrome can occur
Diaphragm
Effectiveness less than that of diaphragm - placed inside vagina against cervix
Toxic shock syndrome can occur
Angle of uterus, vaginal tone, shape cervix may interfere with fitting
Not used often
Educate on dangers on toxic shock syndrome as nurses
Contraindicated for those with abnormal Pap test results
Cervical cap
Failure rate higher than that of the diaphragm
Moisten with water and protection up to 24 hours; repeated instances of sexual intercourse kept in place for at least 6 hours after last episode of sex
Sponge impregnated with n-9
Contraceptive sponge
Combined estrogen-progestin contraceptives (COCs)
Progestin-only contraceptives
Hormonal methods
Oral contraceptives and side effects
Transdermal contraceptive system (Patch); can come off and not realize
Vaginal ring (NuvaRing) - in for three weeks, out for week, new one in after week; effectiveness not high esp out during intercourse and forget put back in
Combined estrogen-progestin contraceptives (COCs)
Suppresses hypo and ant pit leading to insufficient secretion of FSH and LH so follicles not mature and Ovulation is inhibited; ovaries turned off
Contraindications: clotting disorders, liver disease, breast cancer, estrogen dependent cancer, breast feeding post-partum, pregnancy, smoking and older than 35 years old, hypertension, diabetes, and migraines with aura, vascular disease, surgery with prolonged immobility
Oral contraceptives and side effects
Inhibit ovulation, thicken cervical mucus, alter tubal cilia, thin endometrium - not optible for implantation, cannot pass egg, no ovulation, sperm cannot get through
Implantables
when breastfeeding can use
Less effective than combined - take same time every single day - if not, after 3 hours not protected; edu very imp
Less contraindications due to lack of estrogen
Oral progestins (minipill)
Injectable progestins
Implantable progestins (Norplant) - inner arm
Progestin-only contraceptives
