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NURS 326 > Contraception > Flashcards

Contraception Flashcards

1
Q

Contraception

A

Intentional prevention of preg during sexual intercourse
Factor:
* Must. be used correctly and consistently
* Reliable
* Cost
* Protection from STI’s
* Comfort with method

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2
Q

Note on Fertility Control

A

Highly individualized
Preference may depend on variety of factors
* Medical contraindication
* Desire for children
* religious, cultural, and personal belief
* Financial means
* Ability to choose

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3
Q

Forms of Contraception

A

Barrier, Hormonal, Spermicidal, Permanent, Natural Family Planning, Abstinence, Nothing

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4
Q

Barrier Method

Male Condoms

A

Types: Latex, polyurethane, processed animal skin (lambskin)
Multiple texture and colors
Lubricated and non-lub
Efficacy
* Perfect use - 98%
* Typical use - 88%

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5
Q

Pro’s ( Male Condoms)

A

Does not req exam
Inexpensive
Wide variety of choices
Protects from HIV and other STI’s
When used correctly, prevents unplanned preg
Non-hormonal

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6
Q

Con’s (Male Condoms)

A

Requires partner compliance
Does not protect from HPV or HSV

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7
Q

Do’s and Don’ts (MC)

A

**Do’s **
* Apply before ANY penetration occurs
* Leave a reservior tip
* Consider using spermicidal lubricant in addition to condoms
* Know that if a condom breaks, seek Emergency contraception (EC)
* Effective way to reduce your risk of contracting most STI’s as well as pregnancy

Don’ts
* Unroll before applying
* Use the same condom more than once
* Use a condom that has expired
* Use oil based lub
* Store in a wallet or hot place
* Use a condom that causes burning or itching… may be sensitive to latext or spermicidial lub

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8
Q

Barrier Method

Internal Condom

A

Female condom
Placed in vag or anus
Made of nitrile
Efficacy: 79-95%

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9
Q

Barrier Method

Diaphragm

A

Reusable dome-shaped, silicone cup that covers the cervix; insert in vag b/4 sex to prevent preg
Should be **used w/ spermicide **to block sperm
Must remain in place at least 6 hours after intercourse
Need fitting to the size of the cerivx
Needs refitting after delivery or if pt loses/gain weight (>10lbs)
Efficacy with spermicide: 92-96%

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10
Q

Barrier Method

Cervical Cap

A

Made of soft silicone
Covers the cervix
Must be used with spermicide
Can be left in up to 2 dys
Need fitting/ refitting after delivery or weight loss/ gain
Efficacy: 71-88%

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11
Q

Barrier Method

Contraceptive Sponge

A

Soft, disk-shaped device made of polyurethane foam that contains spermicide
Inserted in the vag before sex to prevent sperm from entering the uterus
Efficacy: 76-88%

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12
Q

Spermicide

A

Gels, foams, films, cream, suppositories
Nonoxynol-9: protects against chlamydia and gonorrhea but not HIV
Inserted into the vag before every act of intercourse
No presription needed
Efficacy
* Perfect use- 95-97%
* Typical use- 82%

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13
Q

Toxic Shock Syndrome

A

Life threatening bacterial infection (straph, strep, etc)
Bacteria release toxin into the bloodstream
Link to superabsorbent tampons or tampons left in place for too long
Scratches in the vag allow bacteria to enter
Patient w/ history of TSS should avoid using the contraceptive sponge, diaphram, vag ring, and tampons

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14
Q

Oral Contraceptives (OCPs; “The Pill)

A

Hormonal contraception
Contain sythetic estrogen and progesterone
One pill taken every dy/month
Prevent pregnancy in three ways:
* Inhibts ovulations
* Alter cervical mucus
* Alter endometrial lining

Efficacy: 98-99.5%

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15
Q

Two types of OCPs

Combined Estrogen/Progesterone Pills

A

More freq prescribed
More Effective in preventing preg
Offer non-contraceptive benefits of estrogen

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16
Q

Two types of OCPs

Progesterone Only Pills

mini pill; POPs

A

Used in patients who can’t tolerate combined OCPs or are breastfeeding women
Active pills taken every day- no placebo week
Must be more vigilant in use; less effective than combined OCPs
**Menses likely irregular **
* Example: Micronor

17
Q

Contraindications to OCP use

A

Preg
Undiagnosed vag bledding
Active liver diease
**Migraines w/ neurological symptoms **
* Blurred vision/loss of vision
* Numbness/tingling in face or hand
Estrogen dependent carinoma
Uncontrolled hypretension
Over 35 and smoker
**Depression that worsens with OCP’s use **
History of DVT

18
Q

OCP’s

Common Side Effects

A

Nausea
**Altered Menstural Cycle **
* Break through bleeding (BTB)
* Amenorrhea
Water weight gain
Breast fullness/tenderness
Increased vag discharged

19
Q

Major Adverse Reactions

A

Severe abdominal pain
Sudden change in eyesight
Coughing up blood
Yellowing of skin or eyes
Pain in calves or legs
Weakness/numbness on one side of the body
Severe, recurrent, or presistent headaches

The adverse reactions are more likely to occur in smokers !!!!

20
Q

Signs of Complications w/ OCPs

A

A: abd pain
C: chest pain
H: headaches
E: eye problems
S: severe leg pain

21
Q

Starting OCPs

A

Must be initiated with menses
* First day of cycle ( protected from first pill)
* First sunday in cycle ( protected after 7dys of active pills)

Break through bleeding common in first three months
* Pt need reassurance that this is normal and will stop

22
Q

Preventing Preg while taking OCPs

A

Find out other med interact with OCPs
May decrease effectiveness of OCPs
* Phenytoin ( Dilantin)
* Carbamazepine ( Tegretol)
* Phenobarbital
* Topiramate ( Topamax)

Use back- up method 7days if you:
* Restart your pill
* Have vomitting or diarrhea
* Forget to take your pill

Take pills at the same time each day

23
Q

Non-Contraceptive Benefits OCPs

A

Regulates menstrual cycle
Decreases
* Dysmenorrhea
* Blood loss during menses
* risk of endometrial/ovarian cancer
* Risk of ectopic preg
* Risk of Toxic Shock Syn
* Risk of ovarian cysts
* Risk of benign breast disease
* Risk of osteoporosis

24
Q

OCPs

Pro’s

A

Female controlled
Easily concealed
Approximately same cost as condoms
Wide variety of choice

25
Q

OCPs

Con’s

A

Requires yearly medical exams
Requires daily compliance
Does not protect from STI’s when used alone
Cost-may be partially covered by insurance ( $5-10/month)

26
Q

Emergency Contraception

“The Morning After Pill”
Post-Coital Contraception

A

Hormonal Method
Take within 120 hours (5 dys) of unprotected sex
* No contraception
* Contraceptive failure
* Sexual assault

Two main types
* Ella (ulipristal acetate) Need prescription
* Plan B (Levonorgestrel) Over the counter, best if taken w/in 72 hrs of unprotected sex but can take up to 5dys

27
Q

How EC Works ?

A

Prevents preg by:
* Inhibting ovulation
* Altering the endometrial lining
* Thickening cervical mucus

Does not cause an abortion
Will not disrupt an implanted preg
No major contraindication

EC may postpone ovulation
Side Effects:
* N/V (must take it w/ food), generally offered anti-emetic (tigan), Avoid Alcohol

28
Q

EC

Pro’s

A

Post-coital contrac.
Does not req partner
no Med exam
Few contraindication
May become OTC

29
Q

EC

Con’s

A

Efficacy time dependent
**No protection from STIs **
May be costly
Side effects include N/V
Some pharmacies do not provide
**Mistaken for RU-486 **(Mifepristone- blocks projesterone)
Misinformation among healthcare providers

30
Q

Injectable Contraception

Depo-Provera (DEPO; “The Shot”)

A

**Hormonal method **
Injectable contraceptive
* Depo-Provera Medroxyprogesterone Acetate (DMPA)
* 150 mg progest IM Q3 mos
* Self Admin subq available
* Inhibts ovulation and alters cervical mucus

Good choice for women who:
* Are unable to take estrogen
* Need to conceal contraceptive use
* Would benefit from freq visits to healthcare provider

Poor choice for women who:
** Have history of depression **
* Desire preg in < 1yr
* Can’t follow up with HCP Q3 mos
* *At high risk for STI’s
* Have poor bone density

Efficacy 98-99.5%

31
Q

Contraindication DEPO

A

Preg
Liver disease
Caution in women w/ history of **Depression **
People who have not tolerated progesterone well in the past
Osteoporosis

32
Q

Side Effects of DEPO

A

Altered menses
* Irreg cycle (freq BTB first 3 months) (Amenorrhea)

Weight GAIN
Depression
Osteoporosis
Vag Dryness
Hair loss

33
Q

Hormonal Method

Intrauterine Device (IUD)

A

Hormonal Method
Most commonly used method of contraceptive WW
IUD inserted into uterus
* Copper IUD: replaced q 10yrs
* Mirena: replaced **q 5yrs **

**Creates foreign body inflammation reaction that prevents implantation **
* Good for parous women w/ low STI risk and no history of dsymenorrhea
* Contraindicated if risk of STIs/ PID; history of endocarditis

34
Q
A

NURS 326 (19 decks)

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