Module 4 Exam Flashcards
1
Q
Chemical Contraception
A
- Spermicide: available as a cream, jelly, foam, vaginal film, and suppository.
- Destroys sperm by disrupting cell membrane
- Minimally effective when used alone
- Effectiveness increases when used with barrier method (condom, diaphragm/cap/sponge)
2
Q
Permanent Contraception
A
-Hysterectomy, vasectomy, tubal ligation
3
Q
Vasectomy
A
- vas deferens is severed
- advantages: very effective
- disadvantages: pain, infection, spontaneous reconnecting, does not work immediately, 4-6 wks or 6-36 ejaculations to clear remaining sperm (submit sperm samples for analysis)
4
Q
Tubal ligation
A
- fallopian tubes are clipped/ligated/plugged/banded.
- Essure procedure: stainless steel insert is placed to occlude tube; less invasive
- Advantages: very effective
- Disadvantages: pain, perforation of bowel, infection
5
Q
Contraceptive Barrier Devices
A
male condom female condom diaphragm cervical cap vaginal sponge
6
Q
Male condom
A
- *do not store in hot areas like wallet or glove box**
advantages: helps protect against STD, disposable, cheap
disadvantages: breakable, latex allergy, dulled sensation - *must be applied to erect penis, unroll from tip to base of shaft, small space must be left at end to allow for collection of ejaculate.
7
Q
Female condom
A
- thin sheath with flexible rings at each end. inner ring fits over cervix (closed end) and outer ring remains outside vagina and covers portion of the perineum (open end).
- available OTC, one time use, may be inserted up to 8 hours before intercourse.
- *NOT DESINGED FOR USE WITH MALE CONDOM**
8
Q
Diaphragm
A
- must be fitted by trained personnel, re-fitted after each childbirth and with weight loss/gain 10 - 15 pounds
- insert before intercourse, leave in place 6 hours after intercourse but not longer than 24 hours.
- if intercourse is desired again, another type of contraception must be used or additional spermicide placed in vagina.
9
Q
Cervical cap
A
- similar to but smaller than diaphragm
- requires being fitted by trained personnel
10
Q
Vaginal Sponge
A
- soft absorbent sponge that contains spermicide
- cupped side that fits over cervix
- loop for easy removal (one size fits all)
- sponge is moistened thoroughly to activate spermicide
- may be worn up to 24 hours
- allows for multiple acts of intercourse
- leave in place for 6 hours after intercourse
11
Q
Hormonal contraception
A
- Postcoital Emergency Contraception
- IUD
- Oral contraceptives
12
Q
Postcoital Emergency Contraception
A
- Plan B (progestin only levonorgestrel): inhibits ovulation, fertilization, and implantation
- used within 72 hours of intercourse
- available OTC if over 17 y/o w/o prescription
- Plan B most commonly used
Ella (ulipristal acetate): newly FDA approval, prescription only, can be taken up to 5 days after intercourse.
13
Q
Combined levonorgestrel-ethinyl estradiol
A
- woman uses combined oral contraceptive
- must consult with health care professional
- not recommended because of high intake of estrogen
14
Q
Copper T IUD
A
-lowers risk of pregnancy 99% if inserted within 5 days of intercourse
15
Q
IUD
A
- *check for string placement after each menses**
- Copper T380 (Paragard): copper is spermicidal and prevents sperm from reaching the ovum, inflammatory effects on the endometrium.
- Advantages: lasts 10 years, non-hormonal, easily reversible, can be used as EC
- Disadvantages: causes heavier, longer menses for first few months which should subside, mid-cycle spotting, and uterine perforation
- Levonorgestrel (Mirena): progestin is released which thickens cervical mucus so sperm cannot reach the ovum, endometrial thickening.
- Advantages: lasts 5 years, easily removable, bleeding and length of cycles are reduced, amenorrhea
- Disadvantages: hormonal and possible uterine perforation
16
Q
Oral contraceptives
A
**educate patients to take the same time every day.
**no STD protection
**not effective when on antibiotics
S/S of complications
A - abdominal pain (liver/gallbladder problems)
C - Chest pain/SOB (pulmonary emboli)
H - Headaches (HTN/stroke)
E - Eye problems (HTN)
S - Severe leg pain (DVT)
17
Q
Combined oral contraceptives (COCs)
A
- combined estrogen & progestin
- monophasic, biphasic, triphasic, quadraphasic
- inhibits ovulation and endometrial maturation and thickens cervical mucus.
- comes in 21 days with placebo pills or no pills the last 7 days, 24 days and placebo for 4, and extended-cycle pack you take for 84 days and then take placebo for 7.
- Advantages: lower risk for ovarian, endometrial, and colorectal cancers, mittelschmerz eliminated, relief of menstrual symptoms, lower flow and cramps, more regularity, treats acne
- Disadvantages: must take same time daily, do not take while breastfeeding or at least wait 30 days until breastfeeding is established
- *DO NOT TAKE IF YOU SMOKE OR IF YOU HAVE HX OF DVT OR HTN**
18
Q
Vaginal Ring (combined contraceptive)
A
- NuvaRing
- low dose, sustained release hormonal contraceptive
- soft flexible ring placed for 3 weeks; removed for 1 wk as menses occurs
- one size fits all
- replacement rings are stored in fridge
- Advantage: don’t have to worry about daily
- Disadvantage: not for women who are uncomfortable touching their genitals
19
Q
Transdermal Patch (combined contraceptive)
A
- OrthoEvra
- applied weekly for 3 weeks on abdomen, trunk, buttocks, or upper/outer arm. Patch free week = menses
- Advantage: no daily worry
- Disadvantage: not for women who weight more than 198 pounds
20
Q
Progestin only (minipill)
A
- thickens cervical mucus and suppresses endometrial maturation
- Why chosen over combined oral contraception? for bf mothers, it does not interfere w/ milk production; for people who have side effects or a contraindication to estrogen
21
Q
Injectable Progestin only contraceptive
A
- Depo-Provera
- suppresses ovulation and thickens cervical mucus
- given IM or subQ every 3 months
- Advantages: estrogen free, ok for bf mom’s, convenient
- Disadvantages: menstrual irregularities, headaches, weight gain, breast tenderness, depression
22
Q
Implantable Progestin only contraceptive
A
- Implanon
- prevents ovulation and thickens cervical mucus
- administered subdermally in the upper arm via minor surgical procedure
- Advantages: lasts 3 years, estrogen free
- Disadvantages: spotting, irregular bleeding/amenorrhea, ovarian cysts, weight gain, fluid retention, acne, mood changes, hair loss, depression
23
Q
Behavioral contraception
A
Abstinence
Coitus interruptus (“pulling out”)
Fetrility awareness methods (“natural family planning”)
24
Q
Abstinence
A
The only method guaranteed 100% to prevent pregnancy and STIs
25
Q
Coitus Interruptus
A
- “pulling out”
- failure rate due to pre-ejaculatory fluids
- requires great self-control
26
Q
Fertility Awareness Methods
A
- “natural family planning”
- based on the understanding of the changes that occur during a woman’s ovulatory/menstrual cycle
- takes into account lifespan of perm (2-7 days) and ovum (1-3 days).
- Advantages: free, safe, acceptable to religions, “natural”, immediately reversible, no side effects.
- Disadvantages: women must keep records for several cycles before using them as a means of contraception, difficult/impossible for women with irregular cycles to use, may be less reliable than other methods, limited spontaneity of intercourse
27
Q
Basal body temperature (BBT)
A
- fertility awareness method
- woman takes her temperature each morning, temp drops before ovulation and increases and remains after ovulation
- to avoid conception no intercourse at temp drop and for 3 days after temp goes up
28
Q
Ovulation Method / Cervical Mucus Method / Billings Method
A
- fertility awareness method
- assessment of cervical mucus
- ovulation mucus (estrogen dominant) is clearer and more stretchable (spinnarkeit), more permeable to sperm (also shows fern pattern)
- luteal phase, mucus is thick and sticky (progesterone dominant) which makes the passage of sperm more difficult.
