CNM Varney's Review Book Part A Flashcards
Cycle history last 12 months: shortest 26 days, longest 30 days. According to calendar method, what is the fertile period for this person?
Days 6-20 of her cycle.
Subtract 20 days from the shortest cycle,
subtract 10 days from longest cycle.
Who CANNOT use rhythm/calendar method?
menstrual cycle <25 days irregular cycles cycles that vary in length by 8 days or more postpartum women lactating women perimenopausal women
In order to avoid pregnancy, the woman using the cervical mucus method of family planning should avoid intercourse for a minimum of how many days following the peak day of her cyce?
3 days
What is nonoxynol-9 and how is it beneficial?
Is the active ingredient in most spermicidal preparations and is available without rx.
In the laboratory, is lethal to agents that cause GC, CT. trich, syphilis, and AIDS
Lowers the chance of becoming infected with a bacterial STI/STD
Timing of spermicide use
If you do not have sex within 1 hour of inserting the spermicide, need to reapply it
What lubricants are safe to use with polyurethane condoms?
Safe to use with any lubricant, including oil-based
What is the minimum amount of time after the last act of intercourse that a woman must leave a diaphragm in position in order to maximize contraceptive effectiveness?
6 hours
If a diaphragm is properly fit and cared for, how long is it good for?
2 years
Diaphragm facts
With typical use, failure rate ~18%
Frequency of intercourse significantly affects effectiveness among women who are consistent diaphragm users.
Use of spermicide significantly increases effectiveness of diaphragm.
32 yr old G2P1 successfully used a coil-spring diaphragm prior to birth of her child. Wishes to resume use. PE: uterus retroverted, arch behind symphysis pubis average, first-degree cystocele. Which method birth control to use?
A method other than a diaphragm
C/I in severe cystocele
severe uterine prolapse
severe anteversion or retroversion of uters
fistulas
known allergy to the rubber of the diaphragm or to the accompanying spermicidal preparation
Cervical cap/spermicide in relation to inertcourse
with the cervical cap, additional spermicide is not needed for repeated acts of intercourse
Absolute contraindications for insertion of IUD
recurrent PID pregnancy cervical or uterine carcinoma unexplained or abnormal uterine bleeding hx or presence of valvular heart disease Wilson's dz or allergy to copper uterine sound measurement outside 6-9 cm genital actinomycosis cervical mycosis ...
prerequisites to insertion of IUD
informed consent form
pregnancy test
GC/CT cultures
woman with IUD and +Uhcg is at increased risk for
sepsis
placenta previa
ectopic pregnancy
Which progestin is used as the index progestin in order to compare the biological potency of the various progestins used in oral conntraceptives?
Norethindrone
Why should you delay the initiation of COCP in pp woman who is not breastfeeding?
because earlier initiation of COCP can increase risk of thromboembolism
How soon after a first-term abortion can a woman safely start taking COCP?
immediately
what is the main mechanism of action of COCP to prevent pregnancy?
suppression of ovulation by suppression of FSH and LH
which sx should be reported immediately by a woman who is taking OCP?
hemoptysis (expectoration of blood-tinged mucous)
To ensure maximal contraceptive effectiveness and minimize chances of breakthrough bleeding, when in cycle should OCP be started?
within the first five days of the cycle
for at least how long shoudl a woman use back-up contraception if she has issed two of her COCPs?
7 days
Woman started COCP 2 months ago, is having breakthrough bleeding with each cycle. What do you do?
recommend that she use a back-up method until the bleeding has stopped, and reassure her that in most cases btb will remit by her fourth pill cycle
spotting and btb in early half of cycle (days 1-9), it is most likely due to …
estrogen deficiency
what contraceptives can be used as emergency contraception?
COCP, progestin-only pills, IUDs