Chapter 24 Contraception and Sterilization

Question 1

nursing induced hypothalamic suppression of ovulation. there is a ___ inhibition of pulsatile gonadotrophin releasing hormone from the hypothalamus resulting in suppression of ovulation

Answer 1

prolactin-induced

Question 2

50% of lactating mothers will begin to ovulate between 6-12 months after delivery, even while breastfeeding

Answer 2

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Question 3

return of ovulation occurs before the return of menstruation

Answer 3

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Question 4

effectiveness of lactational amenorrhea only as long as woman is experiencing amenorrhea and, even then, it should only be used for a maximum of __

Answer 4

6 months

Question 5

Progesterone in Mirena thickens cervical mucus and atrophies the endometrium to prevent implantation

Answer 5

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Question 6

copper in paragard is thought to hamper sperm motility and capitation so sperm rarely reach the fallopain tube and are unable to fertilize the ovum

Answer 6

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Question 7

screening women for __ prior to insertion of Mirena IUD

Answer 7

gonorrhea and chlamydia

Question 8

women using mirena IUD have a decreased risk of PID due to

Answer 8

protection fo progesterone-induced cervical mucus thickening

Question 9

__ is aso approved foro emergency contraception when placed within 72 hrs (3days) of unprotected intercourse or contraceptive failure

Answer 9

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Question 10

mirena and paragard can be used safely at 6 weeks postpartum and are safe in breastfeeding women

Answer 10

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Question 11

mirena iud decreases menorrhagia (90%) blood loss and dysmenorrhea it is also as effective as oral progestins in treating endometriosis, endometrial hyperplasia, and cancer. it also protects the user from PID

Answer 11

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Question 12

oral contraceptives place the body in a pseudo-pregnancy state by interfering with the pulsatile release of follicle-stimulating hormone (FSH) and lutenizing hormone (LH) from the anterior pituitary. this pseudo-pregnancy state suppresses ovulation and prevents pregnancy from occurring. because fsh and lh surges do not occur, follicle growth, recruitment, and ovulation do not occur

Answer 12

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Question 13

bleeding that takes place during hormone-free interval is acutaly a bleed due to withdrawal of hormone rather than a menstrual period induced by endomgenous hormone fluctuation

Answer 13

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Question 14

secondary mechanisms of acction for ocps include thickening the cervical mucus to render it less penetrable by sperm and changing the endometrium to make it unsuitable for implantation

Answer 14

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Question 15

advantage of multiphasic dosing is that it may provide a lower level of estrogen and progestin overall, ut is still highly effective at preventing pregnancy

Answer 15

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Question 16

nuvaring

Answer 16

15mcg of ethinyl estradiol and 120mcg of etonogestrel. ring placed in vagina for 3 weeks

Question 17

progestin only pills (POP) deliver small daily dose of progestin (0.35 mg norethindrone) without any estrogen. taken every day of the cycle with no hormone-free days. POPs are believed to thicken the cervical mucus making it less permeable to sperm. other mechanism of action: endometrial atrophy and ovulation suppression .

Answer 17

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Question 18

POP not as effective as combination hormone regimens, with railure rates estimated greater than

Answer 18

8%

Question 19

side effect of progesterone only ocp include

Answer 19

irregular ovulatory cycles, breakthrough bleeding, increased formation of follicular cysts, and acne. POP can also cause breast tenderness and irritability

Question 20

emergency contraception can be used safely in women whom continual estrogen might otherwise be contraindicated, such as women with hx of DVT, PE, myocardial infarction , stroke, or migraines with auras

Answer 20

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