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Nursing Theory I > Contraception > Flashcards

Contraception Flashcards

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1
Q

WHO-Category 1

A

No restriction on use of the contraceptive method

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2
Q

WHO-Category 2

A

Advantages generally outweigh the theoretical or proven risks

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3
Q

WHO-Category 3

A

Theoretical or proven risks usually outweigh the advantages of using the method

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4
Q

WHO-Category 4

A

Condition that represents unacceptable health risk if the contraceptive method is used

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5
Q

What are contraindications for IUDs?

A

Recent exposure to STDs, Hx of pelvic inflammatory disease
CA of the cervix
Abnormalities of the uterine cavity

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6
Q

Plan B (Morning-after Pill)

A

Pill contains an elevated dose of a progesterone-like hormone, WILL NOT AFFECT AN EXISTING PREGANCY

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7
Q

How does Plan B work?

A
  1. Egg release from ovary could be prevented
  2. Could prevent fertilization of egg
  3. Could prevent fertilized egg from attaching to uterus
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8
Q

What is the time limit that someone can use Plan B after having unprotected sex?

A

3 days (72 hours)

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9
Q

What are risks involved with contraception in women over 35?

A

Risks for myocardial infarction stroke, VTE, Breast CA, osteoporosis and bone fx

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10
Q

What test should women at risk for osteoporosis get?

A

Women should get a bone mineral density (Densitometry)

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11
Q

Contraceptive use along with Current breast cancer…

A

Category 4 risk

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12
Q

Contraceptive use along with past breast cancer in remission for 5 years….

A

Category 3 risk

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13
Q

ACOG and the CDC on osteoporosis

A

ACOG and the CDC do not place a resriction on the use of DMPA related to older women

DMPA is associated with a decrease in bone mineral density, with is reversible in younger women.

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14
Q

Benefits to non-contraceptive

A

CHC can help regulate periods and decrease blood loss from heavy, prolonged, unpredictable bleeding
Reduction on endometrial cancer
CHC can help with hot flashes

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15
Q

ACOG recommends against use of CHC in women age 35 and older if the patient…

A 
Smokes
Has HTN
DM
Migraines headaches
Uncontrolled dyslipidemia
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16
Q

Contraindications for IUDS

A

Recent exposure to STDs, Hx of pelvic inflammatory disease, CA of the cervix, abnormalities of the uterine cavity

17
Q

IUD

A

Copper causes sperm dysfunction and prevents fertilization

18
Q

How long does the copper IUD last for?

A

5-10 years

19
Q

If patient cannot find IUD strings…

A
  1. The pt should take a urine pregnancy test, if negative, a cytology brush should be used to try and locate the strings
20
Q

Expulsion rate after initial expulsion of IUD…

A

Expulsion rate of 30%

21
Q

What is CHC?

A

Combined hormonal contraceptives

22
Q

CBC+Diabetes

A

CHC use by women who have diabetes > 20 years or vascular disease is a category 3 or 4

CHC with no vascular disease is category 2

Progestin only pills, implants, or IUDs are category 2

23
Q

CBC+Obesity

A

Use of combined hormonal contraceptives (CHC) in women with a BMI > 35 is contraindicated because of the contribution to cardiovascular issues

The ACOG recommends that CHC be used with caution in obese women over 35 because of the increased risk of VTE

Bariatric surgery may reduce absorption
Eating disorders to avoid weight gain may reduce absorption

24
Q

Obesity+Contraceptive effectivess

A

Body fat can effect hormonal contraception through increased basal metabolic rate, increased hepatic enzyme metabolism, and drug sequestration in fat

Transdermal methods may be less effective in obese women

25
Q

Can LNG-IUDs and DMPA cause weight gain?

A

IUDs have not shown significant weight gain

DMPA the evidence is not conclusive

26
Q

Sickle Cell Disease

A

DMPA reduces the number of painful crises

Reduced bleeding with DMPA improves hemoglobin levels and erythrocyte expectancy

27
Q

Crohn’s Disease+ Contraception

A

Nausea and diarrhea reduces the reliability of absorption by the oral route
Injectable, patches, or IUDs may be a better choice

28
Q

Polycystic Ovarian Syndrome+Contraception

A

Combination contraceptive helps regulate the menses cycle, helps with acne, unwanted hair growth, and protects against endometrial cancer
Low dose COC that contain progestogens provide the best results

29
Q

Medications metabolized by the liver+contraception

A

Medications that induce liver enzymes may reduce the effectiveness of combined hormone medications, and progesterone only medications
Lamotrigine, some HIV medications, and TB medications affect progesterone only contraception
DMPA, Mirena, and non-hormonal contraceptives are not effected

30
Q

Diagphragms

A

Diaphragms need to fitted by a trained NP

Diaphragms need to be inserted 1 hour before and remain 6 hours after sexual intercourse

31
Q

The pill

A

Prevents ovulation by suppressing secretion of gonadotropins
Causes changes in the cervical mucosa, endometrium, and fallopian tubes
Taken in 3 week cycles with a 7 day break from hormones
Consider BMI and BP before prescribing

32
Q

Transdermal Patch

A

Prevents ovulation by suppressing secretion of gonadotropins
Causes changes in the cervical mucosa, endometrium, and fallopian tubes
Taken in 3 week cycles with a 7 day break from hormones
Consider BMI and BP before prescribing

DO NOT APPLY TO BREASTS

33
Q

Contraceptive vaginal ring

A

Delivered via small, flexible, plastic ring that is placed in the vagina for 3 weeks and removed for the 4th week

Prevents ovulation by suppressing secretion of gonadotropins
Causes changes in the cervical mucosa, endometrium, and fallopian tubes

34
Q

Side Effects for Pill/Patch/Ring

A 
Breast tenderness
Spotting between periods
Nausea
Mood swings
Weight gain
headaches
35
Q

Contraindications for pill,patch, and ring

A 
Over 35
BMI greater than 35
Elevated BP
Family history of DVT, stroke, heart disease
Hyperlipidemia
Migraines
Gallbladder disease
History of/or current Breast Cancer
36
Q

Mini pill

A

Consist of only progesterone. Works by thickening the cervical mucosa and can sometimes suppress ovulation.
Can be used if combination pill is contraindicated.

37
Q

Contraindications for mini pill

A 
Current or past history of :
stroke, 
heart disease, 
liver disease, 
systemic lupus, 
current breast cancer, 
breast cancer within the past five years
38
Q

DMPA (Depo Provera)

A

150 mg of medroxyprogesterone acetate.
Given every 12 weeks as deep IM. Can cause amenorrhea
LASTS FOR 5-10 years

Nursing Theory I (3 decks)

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