Ch 8 Contraception And Abortion

Question 1

Unplanned pregnancy rates

Answer 1

50% of all pregnancies are unplanned and 75% of adolescent pregnancies are unintended

Question 2

Family planning

Answer 2

Conscious decision on when to conceive or to avoid pregnancy throughout the reproductive years

Question 3

Contraception informed consent

Answer 3

B: benefits
R: risks
A: alternatives
I: inquiries (chance to ask questions)
D: decisions
E: explanations (education)
D: documentation

Question 4

Fertility awareness-based methods (FAB)

Answer 4

Also known as periodic abstinence or natural family planning

Avoiding intercourse on fertile days

1) infertile phase: before ovulation
2) fertile phase: approximately 5 to 7 days around the middle of the cycle including several days before and during ovulation and the day afterward
3) infertile phase: after ovulation

Question 5

FAB methods

Answer 5

Calendar based methods (calendar rhythm method, standard days method)

Symptoms based methods (today method, cervical mucus ovulation detection method, basal body temperature method, symptothermal method)

Question 6

Spermicides

Answer 6

N-9 reduces sperm motility

Failure rate is 29% in first year alone

Question 7

Barrier methods

Answer 7

Male and female condoms, diaphragm, cervical caps, contraceptive sponge

Question 8

Toxic shock syndrome risks are present with

Answer 8

Diaphragms, cervical caps and sponges

Question 9

Hormonal methods

Answer 9

Prevent the formation of a follicle which inhibits ovulation
Suppressing The surge of the luteinizing hormone

Question 10

Combined estrogen and progesterone administered as

Answer 10

Oral, injection, transdermal patch, vaginal ring

Question 11

Transdermal patch

Answer 11

New patch placed on weekly for three weeks, fourth week no patch

Rotate sites

Question 12

Vaginal ring (nuvaring)

Answer 12

Inserted in to the vagina during the first 5 days of the cycle
Educate to have back up for 7 days after insertion
Removed every three weeks (free of ring for one week)

Question 13

Combined oral contraceptives warning signs

Answer 13

A: abdominal pain (liver or gallbladder)
C: chest pain sob (clot)
H: headaches (cva or htn)
E: eye problems (vascular accident or htn)
S: severe leg pain (thromboembolism)

Question 14

Clots are common with

Answer 14

Nuvaring

Question 15

Pseudo menstruation

Answer 15

Mimics menstrual flow during week without hormones

Question 16

Side effects related to too much estrogen

Answer 16

Nausea vomiting, dizziness, fluid retention, leg cramps, BP unexpectedly high

Question 17

Progestin only contraception

Answer 17

Safer (fewer cardiovascular side effects)
Side effects include: irregular bleeding and spotting, depression, mood changes, decreased libido and weight gain, recurrent yeast infections, acne

Increases viscosity of cervical mucus and inhibits The surge of LH

Oral progestins (minipill) failure rate 9%: take exact time daily, good for breast feeding

Injectable (depovera) 11-13 wks, slows motility of Fallopian tubes, inhibits LH surge, fertility delayed after

implantable rods that can last up to three years

Question 18

IUDs

Answer 18

Four devices: paraguard copper (10 yrs), mirena (5 yrs), liletta (3yrs), skyla (3 yrs)

Failure rate 0.2%

Watch for “aches” acronym

Question 19

Permanent sterilization

Answer 19

Female: tubal occlusion
Male: vasectomy

Question 20

Best time to start ocp

Answer 20

First day of menstrual flow

Can start other time, but backup contraception must be used for 7 days and you must rule out pregnancy first

Question 21

Ocp missed dose

Answer 21

Take missed dose plus schedule tablet= two tabs

With three or more doses missed discontinue the pack wait for withdrawal bleeding and start a new pack

Question 22

If dose is missed with progestin only contraceptives

Answer 22

Take missed dose immediately and use backup contraception for 48 hours