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OB Rotation > Lecture 04 Contraceptives > Flashcards

Lecture 04 Contraceptives Flashcards

1
Q

How much has pregnancy rates drop since 2012?

A

By 10%

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2
Q

What’s the current birth rate for every 1000 for females between 15~19 years old

A

26.5

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3
Q

Females between 15~19 years old account for how many percentage of the 1.7 million reported chlamydia and gonorrhea cases in 2012?

A

25 percent

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4
Q

How much does STDs cost the nation’s health care system each year?

A

As much as 17 billion/year

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5
Q

What are Adolescent Pregnancy Risks? (4)

A
  1. 71% of adolescent mothers receive late or no prenatal care
  2. Increased risk of STI’s including Chlamydia, Syphilis, and HIV
  3. 7% are more likely to smoke which leads to 1. Higher risk for premature birth and low birth weight 2. SIDs
  4. Only half of mothers under age 22 receive a H.S diploma
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6
Q

When suggesting contraceptives, what are some things you should consider?

A
  1. Cost of contraceptive for the woman. Teens may not be able to afford expensive contraceptives 2. What works the best for the woman’s schedule. A teen may not remember to take her POP right on time.
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7
Q

What are the advantages of abstinence?

A
  1. Safe 2. Free 3. Available to all 4. 100% effective perfect use 5. Also prevents many but not all STI’s 6. Encourages partner communication.
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8
Q

What are FAM (Fertility Awareness Method) methods (4)?

A
  1. Calendar Rhythm Method 2. Natural Family Planning 3. Basal Body Temp Method 4. Cervical Mucous Ovulation-Detection Method
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9
Q

What a requirement for Calendar Rhythm and Natural Family Planning methods?

A

Menstrual cycles must be regular

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10
Q

How is the Basal Body Temp done?

A

BBT increases with ovulation, but before it must drop.

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11
Q

How does the cervical mucous ovulation-detection method work?

A

Mucous is spider like thickness, egg white when fertile. It requires females to check quantity and character of mucous for several months.

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12
Q

What is coitus interruptus and who does it not work for?

A

It’s withdraw and requires male to withdraw penis away from the female vagina when the urge to ejaculate occurs. He should ejaculate away from the external female genitalia. This isn’t recommended for teenage boys or men who can’t control their ejaculation.

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13
Q

What are advantages for coitus interruptus?

A
  1. Free 2. Can be practiced anytime during the menstrual cycle
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14
Q

What are disadvantages of coitus interruptus?

A
  • Least effective (< 40%)
  • Males need a fair amount of sexual experience to be able to anticipate ejaculation
  • Not recommended for adolescents
  • No protection against STI’s
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15
Q

What are advantages of condoms? (7)

A
  1. Increased participation for men 2. Sexual intercourse prolonged 3. Variety of size/style condoms 4. Low cost 5. Many condoms protect against STIs (natural skin condoms do not) 6. Female condom may be inserted up to 8 hours before intercourse. Don’t have to depend on men to bring condom. 7. Available without prescription
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16
Q

What are disadvantages to condoms female and male? (10)

A
  1. 80% effective perfect use/ 65% typical use
  2. Requires self control
  3. Condom can rupture/leak
  4. Oil based lubricants can decrease the effectiveness of condoms
  5. Single use only for both types of condoms.
  6. Dulled penile sensaion
  7. Outer ring of female condom may irritate external genitals
  8. Female condoms are higher cost
  9. Female condom insertion can may be difficult/awkward
  10. Noise produced during intercourse & altered sensation with female condom.
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17
Q

What are spermicides & Diaphragms? What are 2 stats with is.

A

They’re chemical and physical barrier to prevent fertilization. 1. Spermicides alone: 70% protection with perfect use/ 60% protection with typical use 2. Spermicides with diaphragm: 94% perfect use/ 80% typical use

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18
Q

What are advantages to using a diaphragm? (4)

A
  1. No prescription for spermicides 2. Spermicides add lubrication 3. Penis can remain in vagina after ejaculation 4. Safe for breastfeeding women
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19
Q

What are disadvantages to having a diaphragm? (10)

A
  1. Not for adolescents 2. Spermicides may be irritating 3. foams are messy 4. May interfere with spontaneity for repeat intercourse 5. Pt teaching increase the need to make sure there’s correct diaphragm placement, it may move during intercourse. 6. Diaphragm must be refitted with +- 10 lbs or pregnancy. 7. diaphragm has to be fitted by HCP 8. Contraindicated with hx of UTIs, cystitis, toxic shock syndrome
20
Q

What’s a cervical cap?

A

Small, thimble shaped device made of soft rubber that fits over cervix, and held in place by suction

21
Q

What are advantages of cervical caps? (same as diaphragms)

A
  1. No prescription for spermicides 2. Spermicides add lubrication 3. Penis can remain in vagina after ejaculation 4. Safe for breastfeeding women
22
Q

What are disadvantages of cervical caps? (9)

A
  1. More difficult to fit: limited sizes 2. Replaced annually, fit by HCP 3. Not recommended for adolescents 4. Need refit if pregnancy, weight gain/loss 5. Device moves during intercourse 6. Awkward to insert and remove 7. Cannot be used during menstruation 8. Contraindicated if hx of Toxic Shock 9. 80% effective perfect use/70% typical use
23
Q

What is a contraceptive sponge? How effective is it? What’s a risk with using this?

A
  1. It’s a small round polyurethane sponge containing nonoxynol 9 spermicide 2. 80% effective with perfect use/70% effective with typical use 3. nonoxynol 9 is irritating to mucous membrane and can cause an increase of WBCs which is attractive to HIV.
24
Q

What are advantages for a contraceptive sponge?

A
  1. Same as diaphragm 2. Low cost
25
Q

What are disadvantages to contraceptive sponges? (4)

A
  1. Awkward when in place 2. Irritation or sensitivity to nonoxynol 3. effectiveness is reduced for parous women 4. Contraindicated with history of toxic shock, or abnormal paps
26
Q

What is TSS, and what is it associated with?

A
  1. Severe acute septic systemic disease usually caused by staphylococcus aureus 2. Associated with use of diaphragm, cervical cap and cervical sponge. Associated with high absorbency tampons as well.
27
Q

What are prevention steps of TSS

A
  1. Prompt removal of diaphragm 6~8 hours after intercourse 2. Don’t use (diaphragm, cervical cap and sponge) during menstruation 3. Prompt removal of sponge after 24 hours
28
Q

What are some symptoms of TSS? (9)

A
  1. temp > 101.4 F 2. Diarrhea and vomiting 3. Weakness and faintness 4. Muscle aches 5. Sore throat 6. Sunburn type rash 7. Late sx: difficult/painful urination 8.Late sx: Ab/pelvic fullness 9. Foul smelling vaginal discharge
29
Q

How does the pill work?

A

It needs to be taken everyday, 3 weeks hormone pills, 1 week placebos. It prevents the release of the egg from the ovaries.

30
Q

What are some side effects of the pill?

A

Nausea, weight gain/loss, breast tenderness, spotting between periods, headaches, missed periods

31
Q

How reliable is the pill?

A

95%

32
Q

When can the morning after pill be taken successfully?

A

Up to 5 days after unprotected IC or contraceptive failure. It doesn’t interrupt an established pregnancy.

33
Q

What types of emergency contraceptives are there? (3)

A
  1. ELLA
  2. Plan B
  3. Paraguard Ella and Plan B aren’t aborting pills. Paraguard can be abortive
34
Q

What’s the main difference between Plan B and ELLA?

A

Plan B won’t work on females if their BMIs are greater than 25%. ELLA will work up to 5 days, regardless of BMI but may be very expensive.

35
Q

How does Paraguard IUD work? How effective is it? What is the action?

A

Paraguard (Copper IUD’s) can be used for EC if inserted within five days after unprotected intercourse. It’s 99.9% effective. The action is to prevent fertilized ovum from implantation.

36
Q

How does Depo Provera work? How effective is it? What are some side effects?

A
  1. It’s a hormone given as a shot every 3 months. It stops the ovaries from releasing an egg. 2. 99.7% effective if the shot is given on time 3. Common side effects: Irregular bleeding, missed periods, headache, weight gain, depression, acne
37
Q

How does Ortho Evra (The Patch) work? How effective is it? What are some side effects?

A
  1. Small thin patch worn in 4 week cycle. Period occurs during week 4 “patch free” week 2. 99% effective Common side effects: headaches, patch site irritation, spotting between periods, abdominal pain, nausea, upper respiratory infections.
38
Q

How does Nuva Ring work? How effective is it? What are some side effects?

A

It’s a small flexible ring that fits in the vagina next to the cervix. Worn for 3 weeks and removed during week 4 It’s 99% effective when used correctly Common side effects: similar to the pill, may be vaginal infections, discharge, weight gain.

39
Q

How does Mirena work? How effective is it? What are some side effects?

A

It’s an intrauterine plastic device that contains hormones and prevents pregnancy for up to 5 years. 99.1% effective Side effects: increased cramping and bleeding in between periods, vaginal discharge and heavy periods

40
Q

What are some Pt teaching points with Mirena?

A
  1. A monthly sting check MUST be done. Mirena gets rid of periods, but so does pregnancy. If the string isn’t there, then pregnancy may have been the cause of missed periods 2. Vaginal bleeding may be irregular the first few months
41
Q

What are benefits of using Paraguard? (3)

A
  1. Hormone free 2. Last up to 10 years 3. 99.4% effective
42
Q

What is Nexplanon (Formerly Implanon)?

A

It’s a flexible plastic single rod implanted into the arm. Does not contain estrogen, just progesterone. Lasts for 3 years. 99% effective

43
Q

What are some side effects of Nexplanon?

A

Irregular bleeding mood swings weight gain headache acne depression

44
Q

What are progesterone only contraceptives?

A
  1. Mirena 2. Depo Povera 3. Nexplanon
45
Q

What barrier method has some degree of protect against STDs?

A

condoms

OB Rotation (11 decks)

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