Contraceptives Flashcards
What are the hormonal contraceptives?
There are 6 needed to be listed
Horomone implants, injections, oral contraceptives, emegency contraceptives, transdermal contraceptive patch, contraceptive vaginal ring
What contraceptives are sterilzation?
There are 2 to be listed
Tubal litigation (female) and vasectomy (male)
What contraceptives are barrier methods?
There are two main subjects with seven subsections
Chemical barriers (creams and gels) and mechanical barriers (male condoms, female condom, sponge, diaphragm, and cervical cap/Lea’s shield)
What methods of natural family planning are there?
There are 6 methods to be listed
Calendar or rhythm method, standard days method, cervical mucus and two day method, symptothermal method, and abstinence
What are the least and most reliable methods of contraceptives?
There are two in least and one in most
The least reliable are breastfeeding and coitus interruptus, most is abstinence
What are the methods of contraceptives?
There are 5
Sterilzation, hormonal contraceptives, intrauterine devices (IUDs), barrier methods, and natural family planning
What is primary infertility?
Difficulty conceiving when there has never been a pregnancy
What is secondary infertility?
Difficulty conceiving after having had a pregnancy, regardless of the outcome
What are benign tumors in the uterus that occupy space within the uterine cavity called?
Fibroids (also called leiomyomas)
q
What are vaginal and cervical factors that affect female infertility?
Acidic pH of normal vaginal discharge and a decrease in cervical connective tissue strength
Acidic pH is pH less than 7
How can the breakdown of cervical connective tissue happen?
There are 4 reasons
Untreated STI; use of an intrauterine device for contraception; multiple elective abortions; or cervical trauma due to a colposcopy procedure, LEEP procedure, cervical cone procedure, or an endocervical biopsy
What factors may negativelt affect female infertility?
Taken from powerpoint
A. Vaginal discharge of 7.4
B. Normal yearly Pap smear
C. Vaginal discharge of 6
D. Intrauterine device (IUD)
E. Endocervical biopsy 2 years ago
Vaginal discharge of 6, intrauterine device (IUD), and endocervical biopsy 2 years ago
Which term describes a benign uterine tumor that
may affect fertility in a woman?
A. Endometritis
B. Bicornuate
C. Septate
D. Myoma
Myoma
What therapies are used to facilitate pregnancy?
There are 5
Medication (ovulation induction), surgical procedures, therapuetic insemination, egg donation, surrogate parenting
How long does hormone implant last?
3 years
What contraceptives prevent STDs?
There are two
Condoms and abstinence
How long does a hormonal injection last?
12 weeks (3 months)
At what age does fertility begin to decline?
35-40
Option choice is usually 35
What are the three most common contraceptives used in the USA?
Male condoms, female sterilization, and oral contraceptives
What is the common age for menopause to happen?
45-50 years old
When are you truly considered to be in menopause?
1 year of amenorrhea
How does progestin affect fertility?
There are three things it does
Progestin inhibits ovulation, thickens cervical muscus to prevent sperm penetrability, and makes the endometrium unfavorable for implantation
How does estrogen affect fertility?
Delays ovulation
(T/F) Irregular menstrual bleeding as a side effect of hormone implants is normal
True
Patients should be taught irregular menstrual bleeding is expected and not a sign of abnormality
(T/F) Unless the ring is inserted on the first day of menses, a backup contraceptive should be used during the first 7 days of the first cycle.
True
Which circumstances require a woman taking hormone injections to use a backup method of contraception?
Taken from sherpath
If the injection site is still tender
If the injection was given subcutaneously 14 days ago
If it has been 15 weeks since the last injection was given
If the injection was given 3 days after the start of the woman’s menstrual period
If it has been 15 weeks since last injection was given
Hormone injections prevent ovulation for 14 weeks, and injections should be scheduled every 12 weeks. If 15 weeks have passed since the previous injection, the woman should use a backup method of contraception.
Which nursing information is appropriate to include when teaching a woman about correct diaphragm usage?
Taken from sherpath
A diaphragm can be used with oil-based lubricants.
A diaphragm can be used with or without spermicide.
A diaphragm is suitable for women with a latex allergy.
A diaphragm must be fitted by a health care provider.
A diaphragm must be fitted by a health care provider
Oil-based lubricants can damage the diaphragm
A diaphragm must be used with spermicide into the dome and around the rim to be effective
A diaphrgm is not suitable for women with a latex allergy
Under which circumstances might a woman need to seek an alternative natural family planning method?
Taken from sherpath
A woman using the standard days method has a menstrual cycle that is 36 days long.
A woman using the symptothermal method has a thermometer that displays temperature in tenths of a degree.
A woman recording basal body temperature (BBT) experiences a slight drop in temperature just before ovulation.
A woman using the 2-day method is unable to distinguish normal cervical secretions from secretions with a sticky, egg-white consistency.
A woman using the standard days method has a menstrual cycle that is 36 days long.
A standards day method is for women’s who’s cycle is 26-32 days
B. The symptothermal method requires a thermometer that displays temperature in tenths of a degree. Therefore has all the necessary equipment needed
C. A drop in temperature just before ovulation is normal and can be used by women recording BBT to determine when ovulation occurs.
D. Using the 2-day method, the woman notes the presence of vaginal secretions of any kind today or yesterday. It does not rely on evaluation of the quality of secretions.
(T/F) Barrier methods or contraceptives that contain only progestin (any form of progesterone) are good choices for older women.
True
Examples include the progestin IUD, DMPA, or progestin-only OCs,
What does the acronym ACHES stand for? What are they a warning sign of? For which contraceptive is this acrynoym used for?
Used for all hormonal methods of contraception that contain estrogen, warning sign of a possible blood clot. Abdominal pain, Chest pain, Headaches, Eye problems, Swelling and/or aching in legs and thighs
DMPA should not be used for more than 2 years because:
DMPA is an injectable progestin-only thatlast for 12 weeks (3 months)
It contributes to bone density loss
It causes decreased estrogen production, which contributes to the loss
What does the acronym PAINS stand for and for which contraceptive is it used?
IUDs; Period late, abnormal spotting or bleeding; Abdominal pain, pain with intercourse; Infection exposure, abnormal vaginal discharge; Not feeling well, fever, or chills; String missing, shorter or longer
A woman who has not had a menstrual period in 6 months wishes to discontinue all contraception methods. Which teaching would the nurse provide regarding contraception during perimenopause?
“You should consider tubal sterilization, just to be sure.”
“We would need to taper off your oral contraceptives to reduce the risk for blood clots.”
“You can stop your oral contraceptives, but you should still use a barrier method to prevent sexually transmitted infections (STIs).”
“We can change your method of contraception, but you should not stop it completely for another 6 months.”
“We can change your method of contraception, but you should not stop it completely for another 6 months.”
Perimenopausal women should continue to use an effective method of contraception until 1 year after the last menstrual period.
Which nursing information is appropriate when teaching a woman who reports discontinuing the use of a diaphragm because of uncertainty about its proper use? Select all that apply.
Tell the woman she will get better at it with practice.
Demonstrate proper usage with a sample diaphragm.
Ask the woman how she normally uses the diaphragm.
Ask the woman what led her to choose the diaphragm initially.
Provide the woman with a handout related to diaphragm insertion
Demonstrate proper usage with a sample diaphragm.
Ask the woman how she normally uses the diaphragm.
Ask the woman what led her to choose the diaphragm initially.
Provide the woman with a handout related to diaphragm insertion
A woman in a nonmonogamous relationship expresses the desire to stop using condoms after the placement of an intrauterine device (IUD). Which patient education on first-time IUD use is appropriate?
“IUD strings can puncture the condom, so there is no point in using them once it has been inserted.”
“Because you are not in a monogamous relationship, you should still use condoms to protect against sexually transmitted infections (STIs).”
“You should wait until after your first menstrual period with the IUD inserted before you stop using condoms.”
“IUDs should only be used by women in long-term monogamous relationships, so it wouldn’t be a good fit for you.”
“Because you are not in a monogamous relationship, you should still use condoms to protect against sexually transmitted infections (STIs).”
A. IUD strings have not been shown to damage condoms
C. Copper IUDs are effective immediately. Hormonal IUDs are effective immediately if inserted within 7 days after the start of a menstrual period.
What days carry the maximum amount of chance of conception for a patient whose shortest and longest amount of time between menstrual periods is 25 and 28 days?
7-17 days
In the calendar rhythm method you subtract 18 from the shortest amount of time and 11 from the longest to get the fertile period
Which self-care guidelines would the nurse teach the patient after elective pregnancy termination?
Sanitary pads would be used in lieu of tampons to avoid infection.
Taking a temperature once daily will increase the possibility of catching infection early.
Light spotting can be expectsl for up to 2 months.
Intercourse should be avoided for 6 weeks after the termination to reduce risk for infection.
Sanitary pads would be used in lieu of tampons to avoid infection; They would be used for the first week after termination to avoid possible infection.
Temp needs to be taken twice daily, bleeding/cramping is for 1 or 2 weeks with light spotting up to 1 month. Intercourse should be avoided for 1 week
What are contraindications of IUDs?
There are 4
Recent or recurrent pelvic infections
A history of ectopic pregnancy
Bleeding disorders
Abnormalities of the uterus
(T/F) IUDs are safe for adolescents and women who have never had a baby
True
(T/F) If IUD strings are different from insertion or previous month/time checked, the patient should contact the health care provider
True
(T/F) Fertility returns when the IUD is removed
True
(T/F) DMPA is an injectable progestin
True, available intramuscular and subcutaneous
DMPA: A backup method of contraception should be used for the first ___ days unless the injection is given within ___ days after a menstrual period starts
The first 7 days unless the injection is given within 5 days after a menstrual period starts
(T//F) Oral contraceptives containing estrogen increase the risk for the patient developing blood clots
True
(T/F) Oral contraceptives are bailable as combination OCs containing both estrogen and progestin or as mini pills that contain only progestin
True
How soon do you have to take emergency contraception after sex?
72 hours max
How long do you take oral contraceptives before the week break for menses?
3 weeks of oral contraceptives, followed by 1 week of placebo pills to allow menses
How long do you wear a transdermal patch before the week-free to allow menses?
3 weeks, then after a week free to allow withdrawal bleeding
(T/F) Backup contraception is necessary for 1 week of use unless the transdermal patch is started on the first day of the menstrual period
True
(T/F) The contraceptive vaginal ring contains estrogen
True
(T/F) A vaginal ring requires a prescription
True
(T/F) A vaginal ring requires fitting/particular placement in the vagina
False, the women can do it herself
How long do you use a vaginal ring before the week-free to allow menses?
3 weeks, then a week free to allow bleeding.
(T/F) Unless the ring is inserted on the first day of menses, a backup contraceptive should be used during the first 7 days of the first cycle
True
(T/F) The vaginal ring can be removed.
True, but if more than 3 hours elapse a backup method is needed until the ring has be used continuously for the next 7 days
When do chemical barriers need to be inserted before sexual intercourse?
30 minutes
(T/F) Diaphragms and cervical caps must be fitted by a health care provider
True
Who should not use diaphragms and cervical caps?
Those with latex allergies
(T/F) A sponge contains hormones
False, contains no hormones
How long does the sponge provide contraception for?
24 hours
(T/F) A sponge requires an order from a provider
False
What is the female condom? Where does it fit over?
A flexible ring inside the closed end of the condom that fits over the cervix like a diaphragm. Another ring extends outside the vaginal to partially cover the perineum.
How does cervical muscus assessment work?
he cervical mucus technique is based on changes in cervical mucus that are assessed by wiping the vaginal orifice with a tissue daily.
Cervical mucus: There is no mucus for the first 3 to 4 days after menses, and then what quality of mucus appears? Is this where fertility occurs?
Thick, sticky mucus begins to appear. This is not when women are most fertile.
Cervical mucus method: As estrogen increases, the mucus changes to what quality of mucus? Is this where fertility occurs?
Clear, slippery, and stretchy, like egg white (a quality known as spinnbarkeit). This is when women can become pregnant/most fertile
Cervical mucus method: To prevent pregnancy, couples should avoid intercourse from what points?
The time the mucus is first present after menses until four days after the end of the slippery mucus
What is the two day method?
The women assesses her mucus daily, if she notices any vaginal secretions of any kind today or yesterday, she considers herself fertile.
(T/F) Basal body temperature drops slightly just before ovulation
True
What is BBT? What happens to it during the time of ovulation?
Basal Body Temperature is the lowest or resting temperature of the body, which raises slightly near the time of ovulation.
(T/F) Progesterone is secreted during the second half of the cycle, rising just after ovulation.
True, it causes an increase in BBT.
(T/F) The BBT rises near ovulation and remains higher during the second half of the cycle.
True
(T/F) The BBT remains higher if conception occurs
True
If conception does not occur, when will the BTT fall?
The BTT falls about two to four days before menstruation if fertilization does not occur.
When should couples not have sex in regards to BTT?
From the first day of the menstrual cycle until three to four days after the temperature elevation (which signifies fertilization period) has occurred.
For BTT, women should use a thermometer to what degree?
The tenth degree
What is the symptothermal method? What two other methods of natural family planning does it use?
Combines assessment of BBT (body temperature at rest) and cervical mucus daily. Symptoms that occur near ovulation, such as weight gain, abdominal bloating, mittelschmerz (pain on ovulation), or increased libido (sexual desire), are noted.
What is standard days method?
This method uses a string of color-coded beads to help keep track of the fertile and infertile days of each cycle.
Who can use the standard days method? Which days are considered fertile days?
By women with cycles that range from 26 to 32 days in length but is ineffective for other women. Days 8 through 19 are considered fertile days.
What is the calender/rhythym method?
Based on the timing of ovulation, approximately 14 days before the onset of menses. The couple must abstain or use another contraceptive method during the days calculated to be fertile.
What methods contain progestin-only? There are 3
Progestin IUD, DMPA, progestin-only oral contraceptives
Which methods contain estrogen? There five
Emergency oral contraceptives, combined oral contraceptives, hormonal contraceptives, transdermal patch, vaginal ring
Which methods have no hormones? There are 6
Copper IUD, diaphragm, cervical cap, sponge, female and male condoms,
(T/F) The single-rod etonogestrel implant is safe during lactation, and fertility returns within a few weeks after removal
True
Match the contraception method with the manner in which it can prevent pregnancy.
Creates a physical barrier that prevents the sperm from reaching the egg
Creates a spermicidal environment through a sterile, inflammatory response
Delays or inhibits ovulation Intrauterine device
Prevents sperm from entering semen during ejaculation
Male condom
Emergency contraceptives
IUD
Vasectomy
Creates a physical barrier that prevents the sperm from reaching the egg **Male condom **
Creates a spermicidal environment through a sterile, inflammatory response ** Emergency contraception (EC) **
Delays or inhibits ovulation **Intrauterine device (IUD) **
Prevents sperm from entering semen during ejaculation Vasectomy
A woman is seeking a long-term contraceptive method that does not require taking daily medication or applying a device before intercourse. Which contraceptive methods would the nurse recommend? Select all that apply
Lea’s Shield
Single rod etonogestrel implant
Contraceptive Sponge
IUD
Combined oral contraceptive
Single rod etonogestrel implant
IUD
