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HRM Test 2 > Contraception Management > Flashcards

Contraception Management Flashcards

1
Q

If using the calendar method, when should a woman sustain from intercourse?

A

5 days before ovulation until 3 days after

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2
Q

If a women has a longer cycle (32) days, how would you figure out when ovulation is?

A

Subtract 14 days from onset of menses….. so ovulation would occur at day 18

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3
Q

Some using FNP take their temperature… why?

A

Basal body temperature is high during progesterone phase

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4
Q

What does cervical mucous look like around time of ovulation?

A

Watery

“consistency of egg whites”

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5
Q

Best STI protection

A

CONDOMS!

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6
Q

What kind of lubricants should you use with condoms?

A

Water based! Others can break down the condoms

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7
Q

Do diaphragms prevent STI’s?

A

Decreases STIs but does not prevent them!

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8
Q

When must the diaphragm be inserted?

A

2 hours before sex
MUST leave in at least 6 hours after!
(not more than 24 total)

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9
Q

A downfall of diaphragms?

A

Increased rate of UTIs, puts a little extra pressure on the urethra

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10
Q

What would be a good option if a patient is have problems with increased UTIs from diaphragm?

A

Cervical cap

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11
Q

How do hormonal methods of contraception work? (3 ways)

A

Estorgen-progesterone induced inhibition of the mid-cycle surge of gonadotropin secretion

So ovulation does not occur

Also makes cervica mucous inhospitable to sperm transit

And makes endometrium less hospitable to conceptus

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12
Q

What are some ABSOLUTE contraindications for hormonal contraceptives?

A
  1. Thomboembolic event/stroke
  2. Hx of CAD
  3. Estrogen dependent tumor
  4. Liver disease
  5. Undiagnosed abnormal uterine bleeding
  6. SMOKER over 35
  7. Migraines w/ neuro symptoms
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13
Q

What are some RELATIVE contraindications?

A
  1. Obesity
  2. Thrombophilias
  3. HTN
  4. Depression
  5. Lactation (can use progesterone only pill)
  6. Seizure meds
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14
Q

Main medical concern of starting the pill?

A

Increase in thromboembolic events

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15
Q

What is the pill made up of?

A
  1. Estrogen component = ethinyl estradiol with doses from 10-50 mcg
  2. Choice of what progestin is best for patient
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16
Q

Which progestin do you see a slight increase in lipid profile?

A

Norethindrone (1st gen)

17
Q

What combo pill is good for starting out someone on a pill for the first time?

A

Ethinyl estradiol + norethindrone (1st gen)

18
Q

What is the most widely prescribed progestin?

A

Levonorgestrel (2nd gen)

19
Q

who would be a good candidate for a third generation progesterone?

A

Patients with dyslipidemia, acne or other possible androgenic side effects

Higher risk for thrombus then 1st and 2nd gen (but still less than pregnancy)

20
Q

How should you adjust pill if patient is having break through bleeding in first 10 days vs. after 10 days?

A

First 10 days = increase estrogen

After 10 days = increase progestin

21
Q

How should you adjust pills if patient is having no withdrawal bleed (and would like one)?

A

Increase estrogen

22
Q

Describe how the nuvaring works

A

Worn intravaginally for three weeks and then out for one week

**if falls out for > 3 hours use back up contraception

Comparable efficacy to OCP

23
Q

Who should get the mini pill? (progesterone only)

A
  • Patients that need to avoid estrogen
  • Many side effects to combo pill
  • NURSING- won’t affect milk supply
24
Q

Up and downs to the progesterone only pill?

A

Downs:

  • will NOT have regular periods to start out with
  • Chance of break through OVULATION if pills are missed

Ups:
LITTLE risk of thrombus, stroke

25
Q

With the progesterone only pill when would you need to use back up contraceptives?

A

Timing is critical! Take pill with-in 3 hours or back up contraception is needed

26
Q

Why should the depo-provera shot be limited to 2 years?

A

Concern with bone health

Evidence for bone resorption, reduction in BMD probably due to induced estrogen deficiency

27
Q

The depo shot would be good for who?

A

Teen mom who doesn’t want to get pregnant again

Probably not good for someone inbetween babies who would like to have one in near future…… return to fertility

28
Q

Can you get plan B over the counter?

A

Yep!

29
Q

How soon do you need to take emergency contraception?

A

Plan B- with in 72 hours

Ella- with in 120 hours (5 days)

30
Q

MOA of emergency contraceptive?

A

Give progesterone…. no one knows why…..

31
Q

MOA of cooper IUD/ Paraguard?

A

induces forgein body reaction in the endometrium, resulting inflammatory response preventing viable sperm frmo reaching fallopian tubes

32
Q

Mirena/Skyla contain what hormone?

A

Levonorgestrel (2nd gen progestin)

33
Q

Contraindications of IUD?

A 
Pregnancy
Congenital uterine malformation
Acute STD, cervicitis, vaginitis
Neoplasia
Unknown bleeding

HRM Test 2 (16 decks)

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