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OB Exam 4 Women's Health Flashcards

1
Q

when should mammograms for breast cancer be?

A
  • 40-45: Optional Yearly
  • 45-54: Yearly
  • 55+: Every 2 years
  • High Risk – Breast MRI and Mammogram Yearly – Age 30+
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2
Q

when should screenings for cervical cancer be?

A
  • 21-29 years: Pap Test every 3 years
  • 30-65 years: Pap Test + HPV test every 5 years
  • > 65 years: screening is unnecessary if no precancerous cells in past 20 years
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3
Q

who is at risk for breast cancer?

A
  • -Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing)
  • -Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
  • -Had radiation therapy to the chest when they were between the ages of 10 and 30 years
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4
Q

what is menarche

A
  • -Girls: Ages 8-13
  • -Menarche: Initial Menstrual Period
  • -Occurs 2-2.5 years after the beginning of puberty
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5
Q

what triggers puberty

A
  • -Puberty triggered by the production of gonadotropin-releasing hormone from the hypothalamus→
  • -Gonadotropins stimulate the ovaries to secrete estrogen🡪
  • -Estrogen → development of secondary sex characteristics
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6
Q

what is menopause

A

Menopause = Permanent cessation of menstrual activity

–Natural, biological process occurring between ages 35-58

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7
Q

what are the 3 stages of menopause

A
  • perimenopause
  • menopause
  • postmenopause
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8
Q

what is perimenopause

A

Perimenopause (BEFORE)

  • -40’s
  • -Lasts 4-8 years
  • -Irregular Menstrual Cycles
  • -Pregnancy still possible
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9
Q

what is menopause

A

Menopause (DURING)

  • -12 months after LMP (last mens period)
  • -Average age: 51 (48-58)
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10
Q

what is postmenopause

A

Postmenopause (AFTER)

  • -Time after menopause
  • -no period
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11
Q

what happens in 30s regarding ova?

A

in 30s → decline of ova →gradual decline in estrogen and progesterone production

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12
Q

what are sx of menopause

A
  • -anovulatory = menstrual cycle changes
  • -Hot Flashes
  • -Night Sweats
  • -Sleep Disturbances
  • -Sexual Dysfunction
  • -dyspareunia
  • -Hair Loss/Hair Thinning
  • -Food Cravings
  • -Dry Skin/Loss of Skin Elasticity
  • -Weight Gain – Hips/Waist
  • -Irregular Heartbeat/Palpitations
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13
Q

what are triggers of hot flashes

A

Warm Rooms
Alcohol & Caffeine
Hot/Spicy Foods
Stress

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14
Q

what is dyspareunia from vaginal atrophy

A

painful intercourse from changes in estrogen→ not lubricated

– from vaginal atrophy

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15
Q

what are psychological sx of menopause

A 
Mood Swings
Irritability
Anxiety
Lack of Energy
Panic Attacks
Forgetfulness
Difficulty Coping
Depression
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16
Q

what are lifestyle changes to treat menopausal sx?

A 
8 hours of sleep/night
Balanced Diet
Weight Management
Exercise
Avoid Caffeine/Alcohol
Avoid Smoking
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17
Q

What are 3 treatments for menopause sx

A
  • -lifestyle changes
  • -menopause hormone therapy
  • -alternative medicine
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18
Q

what is menopause hormone therapy (MHT)

A

Estrogen Replacement
Oral, Transdermal, Vaginal
Non-Hysterectomy:
–Progesterone + Estrogen: Prevents Uterine Cancer

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19
Q

what are alternative medicine tx for menopause

A

Herbal Supplements
Acupuncture
Hypnosis
Biofeedback

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20
Q

osteoporosis

A

Loss of bone mass that occurs when more bone mass is absorbed than the body creates

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21
Q

when does the decline of bone mass start

A

35

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22
Q

what is a DEXA scan

A

Dual Energy X-Ray Absorptiometry

–Measures bone density in the hip, spine, and forearm

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23
Q

score difference between osteoporosis and osteopenia

A

> = -2.5: Osteoporosis

-1 to -2.5: Osteopenia

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24
Q

what are manifestations of osteoporosis

A
  • -loss of height(collapsed vertebrae)
  • -back pain (collapsed vertebrae)
  • -stopped posture (collapsed vertebrae)
  • -bone fractures (bone weakness)
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25
Q

risk factors for osteoporosis

A
  • -caucasian
  • -hip fractures
  • -smoking
  • -inactive lifestyle
  • -Ca and vitD deficiency
  • -alcohol 3/more drinks/day
  • -BMI over 20
  • -anorexia
  • -weight loss surgery
  • -meds (prednisone, aromatase inhibitors, proton pump inhibitors)
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26
Q

what 3 meds are risk factors for osteoporosis

A
  • -Corticosteroids (prednisone)
  • -Aromatase inhibitors
  • -Proton Pump Inhibitors
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27
Q

how to decrease risk of osteoporosis

A
  • -Diet high in Calcium/Vitamin D
  • -Weight-bearing exercise 3-4x/week
  • -Avoid Smoking
  • -Limit Alcohol Use–leads to lower bone density
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28
Q

drug for osteoporosis and action

A

Biphosphonates
–Fosamax (Alendronate), Boniva (Ibandronate)

–Action: Inhibits resorption of bone

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29
Q

SEs of biphosphonates for osteoporosis

A

Musculoskeletal aches & pains
GI irritation
Esophageal ulcers

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30
Q

considerations for biphosphonate administration

A
  • -Empty Stomach – 30 mins before breakfast
  • -8oz water – not juice, coffee, tea
  • -Take medication in a sitting or standing position
  • -Remain upright for 30 minutes to decrease reflux
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31
Q

infertility

A

–Infertility = The inability to conceive and maintain a pregnancy after 12 months of unprotected sexual intercourse

–6 months if older than 35

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32
Q

causes of female factors of infertility vs male

A

1/3 female factors

  • -Ovulatory Dysfunction
  • -Tubal Damage
  • -Cervical (Infection, Surgery)

1/3 male factors

  • -Endocrine
  • -Spermatogenesis

1/3 combo male/female

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33
Q

what are details of male causative factors for infertility

A
  1. Endocrine causes include pituitary diseases, pituitary tumors, and hypothalamic diseases that may interfere with male fertility. Low levels of LH, FSH, or testosterone can also decrease sperm production.
  2. Spermatogenesis–chemotherapeutics, calcium channel blockers, heroin, and alcohol; Infections/viruses; prolonged testicular heat exposure; pesticide exposure, radiation
  3. Sperm antibodies are an immunological reaction against the sperm that causes a decrease in sperm motility.
  4. Sperm transport factor includes missing or blocked structures in the male reproductive anatomy that interfere with sperm transport (prostatectomy)
  5. Disorders of intercourse include erectile dysfunction (inability to achieve and/or maintain an erection), ejaculatory dysfunctions (retrograde ejaculation), anatomical abnormalities (hypospadias), and psychosocial factors that can interfere with fertility.
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34
Q

what are details of female causative factors for infertility

A
  1. Ovulatory dysfunction includes anovulation or inconsistent ovulation from Hormonal imbalances; Hyperthyroidism/ hypothyroidism; High prolactin levels; Premature ovarian failure (menopause prior to age 40); Polycystic ovarian syndrome
  2. Tubal and pelvic pathology factors include damage to the fallopian tubes and uterine fibroids.
  3. Cervical mucus factors include infection and cervical surgeries such as cryotherapy, a medical intervention used to treat cervical dysplasia. These factors may interfere with the ability of sperm to enter or survive in the uterus.
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35
Q

what are male risks for infertility

A 
Environmental pollutants
Heavy use of alcohol, THC, cocaine
Impotence
Older age
STIs
Smoking
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36
Q

what are female risks for infertility

A 
Autoimmune Disorders
Diabetes
Eating disorders, poor nutrition
Excessive alcohol use
Excessive exercising
Hx of cancer treated with radiation, chemotherapy
Obesity
Older age
STI’s
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37
Q

what are tests to determine infertility

A
  • Screening for STI’s
  • Laboratory Tests: TSH, FSH, LH, Testosterone
  • Semen Analysis
  • Ovulatory Dysfunction Analysis
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38
Q

what 4 things are part of an Ovulatory Dysfunction Analysis

A

BBT
Ovulatory Prediction Kits
Ovarian Reserve Testing
Detecting LH Surge

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39
Q

what are the emotional implications of infertility

A

roller coaster effect, relationship crisis, emotions, self esteem issues

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40
Q

Male treatments for infertility

A
  • -Hormonal Therapy = endocrine factors
  • -Lifestyle Changes = correct sperm count
  • -Corticosteroids = decrease sperm antibodies
  • -Antibiotics = clear UTI
  • -Varicocele/Hernia Repair = facilitate sperm transport
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41
Q

Female treatments for infertility regarding anovulation

A

Anovulation

  • -Lifestyle Changes = stress, smoking, diet, drugs
  • -Drug therapy to stimulate ovulation = clomiphene citrate (high success rate); letrozole; injectable gonadotropins; gonadotropin-releasing hormone [GnRH] pump; and bromocriptine
  • -Surgery to open fallopian tubes
  • -Myomectomy = removal of uterine fibroids
  • -Antibiotics = infection of cervix
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42
Q

What is Clomid (Clomiphene Citrate) for and how does it work?

A
  • -Indication: for anovulatory Infertility
  • -Action: Stimulates release of FSH and LH, which stimulates ovulation
  • -Cycle day 3-7
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43
Q

What are SEs of Clomiphene Citrate

A 
Hot Flashes
Breast Discomfort
Headaches
Insomnia
Bloating
Blurry Vision
Nausea
Vaginal Dryness
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44
Q

What are 3 ART: Assisted Reproductive Technologies for infertility

A
  • -Artificial Insemination (AI) = sperm put into cervix
  • -In Vitro Fertilization – IVF = oocytes harvested and fertilized in lab
  • -Embryo Transfer = embryo placed in uterus
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45
Q

what are ethical implications of Assisted Reproductive Technologies for infertility

A
  • -Surplus Embryos
  • -Ownership of Embryos
  • -Access - Cost
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46
Q

what is artificial insemination

A

sperm from masturbation put into cervix

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47
Q

what is IVF

A

oocytes harvested and fertilized in lab

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48
Q

what is embryo transfer

A

embryo placed in uterus

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49
Q

what are diagnostic procedures for infertility

A
  • -Bone Mineral Densitometry
  • -Breast Biopsy/Aspiration
  • -Cervical Conization
  • -Colposcopy
  • -Dilation & Curettage
  • -Endometrial Biopsy
  • -Laparoscopy
  • -MRI
  • -Ultrasonography
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50
Q

what does a bone mineral density test find

A
  • -Diagnose bone loss and osteoporosis
  • -Assess effectiveness of osteoporosis medication therapy
  • -Predict risk of future bone fractures
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51
Q

what is a DEXA scan and considerations regarding supplements and metal

A

Dual-energy x-ray absorptiometry (DXA) Scan

  • -X-ray is usually of the lower spine and hip
  • -Remove metal from X-Ray area
  • -No calcium supplements for 24 hours before exam
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52
Q

why are breast bx done

A

Breast abnormality noted by palpation, mammography, or ultrasound
–BIOPSY USED FOR DX

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53
Q

what is a colposcopy and what is it used for

A

–Speculum for visualization of vagina/cervix
Acetic Acid placed on the cervix
Colposcope – microscope with light
Biopsy of whitest area

–indicated for Dysplasia, condylomas, and abnormal Pap smear, used to rule out cancer of the cervix

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54
Q

what is cervical conization (cone bx or LEEP procedure)

A

Removal of a cone-shaped portion of cervical tissue

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55
Q

what is a LEEP procedure

A

Loop Electrosurgical Excision Procedure (cuts wedge of cervix and cauterizes at same time)
–AKA cone biopsy/conization

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56
Q

why do a conization procedure

A

for bx of abnormal Pap Smear to detect cervical cancer or for treatment of a cervical intraepithelial lesions

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57
Q

what is dilation & curettage for

A
  • -Detect uterine malignancy
  • -Evaluate fertility
  • -Evaluate dysfunctional uterine bleeding
  • -placental fragments tx
  • -Molar pregnancy tx
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58
Q

what is a therapeutic reason for dilation and curettage

A

to treat heavy uterine bleeding, dysmenorrhea, and incomplete abortion

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59
Q

hysterectomy

A

Surgical Removal of the Uterus

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60
Q

reasons for hysterectomy

A
  • -Leiomyomas (fibroids)
  • -Endometriosis
  • -Prolapsed Uterus
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61
Q

what are the 4 types of hysterectomy

A
  • -Supracervical or Partial
  • -Total Hysterectomy or “Simple”
  • -Hysterectomy with Bilateral Salpingo-Oophorectomy
  • -Radical Hysterectomy
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62
Q

what therapy is used if ovaries are removed

A

Hormone replacement therapy

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63
Q

what are surgical techniques for hysterectomy

A
  • -Abdominal Hysterectomy (preferred)
  • -Vaginal Hysterectomy
  • -Laparoscope-Assisted Vaginal Hysterectomy (LAVH)
  • -Robotic-Assisted Laparoscopic Hysterectomy
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64
Q

what are risks of surgery for hysterectomy

A
  • Injury to ureters, bladder, bowel
  • Hemorrhage
  • Infection
  • DVT
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65
Q

what is a risk of Laparoscope-Assisted Vaginal Hysterectomy (LAVH)

A

bladder injury and UTI

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66
Q

what position is woman in for Robotic-Assisted Laparoscopic Hysterectomy

A

Trendelenburg

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67
Q

what is Primary Dysmenorrhea

A
  • -Painful menstruation: Cramping usually begins 12–24 hours before onset of flow and lasts 12–24 hours.
  • -chills, nausea, vomiting, headaches, irritability, and diarrhea.
  • -Excessive endometrial production of prostaglandin; women with primary dysmenorrhea produce 10 times the amount of prostaglandin. Prostaglandin is a myometrial stimulant and vasoconstrictor
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68
Q

what is Secondary Dysmenorrhea

A

–Painful menstruation associated with known anatomic factors or pelvic pathology.
Pain can be present at any point of the menstrual cycle.

--Related to:
• Endometriosis
• Pelvic adhesions
• Inflammatory disease
• Cervical stenosis
• Uterine fibroids
• Adenomyoma
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69
Q

what is PMS

A

Premenstrual syndrome = A combination of emotional and physical symptoms that begin during the luteal phase and diminish after menstruation begins.

s/sx
–lower abdominal and back pain, bloating, weight gain, breast tenderness, joint and muscle pain, oliguria, diaphoresis, diarrhea, constipation, nausea, vomiting, food cravings, acne, urticaria, headaches, vertigo, fainting, clumsiness, mood swings, depression, irritability, anxiety, lethargy, fatigue, confusion, tension, forgetfulness, sexual arousal or dysfunction

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70
Q

what is menorrhagia

A

heavy or prolonged menstrual bleeding

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71
Q

what is metrorrhagia

A

abnormal bleeding from the uterus from stress or meds or other

72
Q

what is Primary Amenorrhea

A

absence of menses at age 15 years in the presence of normal growth and secondary sexual characteristics

73
Q

what is secondary amenorrhea

A

the absence of three or more periods in a row by someone who has had periods in the past

74
Q

what is PCOS

A
  • -Polycystic Ovary Syndrome (Stein-Leventhal Syndrome)
  • -Endocrine Disorder characterized by Elevated Estrogen, Testosterone, and LH and Decreased FSH
  • -most common cause of female infertility
75
Q

what are Multiple Follicular Cysts

A

PCOS

–hormonal changes can cause multiple follicular cysts on one or both ovaries

76
Q

what are risks of PCOS

A

Main 4:

  • -Type 2 diabetes
  • -Sleep Apnea
  • -Hypertension
  • -Infertility
  • -Endometrial, ovarian, and/or breast cancer
  • -Dyslipidemia
  • -Infertility
  • -Pregnancy and birth complications
  • -Metabolic syndrome
  • -Cardiovascular disease
77
Q

what are clinical manifestations of PCOS

A

Main 4:

  • -Infertility
  • -Hirsutism
  • -Obesity
  • -Pelvic Pain
  • -Menstrual Disorders
  • -Ovarian Cysts
  • -Oily Skin/Acne
  • -Male-Pattern Baldness
78
Q

what are 4 ways of managing PCOS

A
  • -Diet & Exercise for Weight Loss = Chain Reaction
  • -Hormone Therapy = Low-Dose Hormonal Contraceptive, anti-androgen meds
  • -Fertility Therapy= Clomid; ART, IVF
  • -Antidiabetic Medications = Metformin
79
Q

what does hormone therapy do for PCOS

A

contraceptives inhibit LH production, decrease testosterone levels, and reduce the degree of acne and hirsutism.

80
Q

what can diabetic meds do for PCOS

A

lower blood glucose levels and can lower testosterone, which reduces the degree of acne, hirsutism, and abdominal obesity and may help regulate the menstrual cycle and treat infertility.

81
Q

what is endometriosis

A
  • -Chronic Inflammatory Disease

- -Presence & Growth of Endometrial Tissue Outside the Uterine Cavity (Endometrial Lesions)

82
Q

lesions respond to changes in what hormones in endometriosis

A

estrogen

progesterone

83
Q

what is retrograde menstruation

A

in endometriosis, menstrual flow is reversed

  • -Menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body
  • -Cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
84
Q

what are clinical manifestations of endometriosis

A
  • -Pelvic pain and dysmenorrhea
  • -Pelvic pressure
  • -Dyspareunia
  • -Infertility
  • -Premenstrual spotting and menorrhagia
  • -Low back pain
  • -Diarrhea, pain with defecation, and constipation
  • -Bloody urine and dysuria
  • -Enlarged & tender ovaries

1/3 of people are asymptomatic

85
Q

what is the medical management for endometriosis

A
  • -Analgesic Therapy
  • -NSAIDS
  • -Hormonal Therapy = Goal: Suppress Menstruation & Tissue Growth, OCP’s, Progestins
  • -Surgical Treatment = Laparoscopy Removal of Lesions; Hysterectomy w/Bilateral Salpingo-Oophorectomy
  • -ART = IUI, IVF
86
Q

for endometriosis, what is Laparoscopy Removal of Lesions

A

laparoscopy procedure and laser treatment is used for women with severe symptoms who are infertile and desire pregnancy.
Endometriosis may recur after surgical intervention.

87
Q

for endometriosis, what is Hysterectomy w/Bilateral Salpingo-Oophorectomy

A

Hysterectomy with bilateral salpingo-oophorectomy and removal of adhesions and lesions is used for women with severe symptoms who do not desire pregnancy.

88
Q

what is ovulation induction used for in women with endometriosis

A

Ovulation induction with intrauterine insemination or in vitro fertilization may be used for infertile women with endometriosis who have not responded to other therapies for infertility

89
Q

what is pelvic organ collapse

A
  • -Weakened Pelvic Muscles –> Pelvic Organs Descend into the Vagina
  • -Can affect Bladder, Urethra, Uterus, Rectum
90
Q

what are risk factors

A
  • -Childbirth Trauma = Vaginal Birth, Large Babies, Forcep/Vacuum Deliveries
  • -Stress/Strain = Heavy lifting, constipation, violent coughing
  • -Obesity
  • -Menopause
  • -poor suturing/repair of episiotomies/lacerations
91
Q

what is the effect of menopause on the pelvic floor muscles

A

Menopause: Low levels of estrogen weaken the pelvic floor muscles.

92
Q

what is uterine prolapse

A

uterus comes out

93
Q

what is prevention for uterine prolapse

A
  • -Importance of Kegel Exercises
  • -Treatment/Prevention of Constipation
  • -Avoid Heavy Lifting
  • -Weight Management
94
Q

what is vaginal pessary used for for uterine prolapse

A

Vaginal pessary: A rubber or silicone-based ring placed in the vagina to support the uterus; effective for a mild degree of uterine prolapse

95
Q

what surgery may be needed for uterine prolapse

A

hysterectomy may be needed

96
Q

what are risk factors for breast cancer

A
  • -Increasing Age (55+)
  • -Genetic – BRCA1, BRCA2
  • -Dense Breasts
  • -Hx Breast CA
  • -Head/Chest Radiation
  • -Smoking, carcinogen exposure
  • -Estrogen (early menarche, late menopause, hormonal therapy)
97
Q

what does a breast ultrasound look for?

A

Breast ultrasounds assist in determining if the area of concern is a fluid-filled cyst or solid mass.

98
Q

what is an MRI of the breast useful for?

A

MRI is useful in differentiating benign from malignant tissue, especially in women with dense, fibroglandular breasts; when scar tissue is present from previous breast surgery; and for new tumors in women who have had previous lumpectomy. Yearly screening MRI and mammogram are recommended for women at high risk for breast cancer

99
Q

what do diagnostic mammograms of the breast show regarding a mass

A

size and character of the mass

100
Q

what is a lumpectomy for breast cancer

A

Lumpectomy: The lump and an area of surrounding normal tissue are removed. This procedure is usually followed by radiation therapy.

101
Q

what is a partial or segmental mastectomy for breast cancer

A

Partial or segmental mastectomy: The tumor, the surrounding breast tissue, a portion of the lining of the chest wall, and some of the axillary lymph nodes are removed. This procedure is usually followed by radiation therapy.

102
Q

what is a simple mastectomy for breast cancer

A

Simple mastectomy: All the breast tissue along with the area surrounding the nipple and areola are removed. This procedure may be followed by radiation therapy, chemotherapy, or hormone therapy.

103
Q

what is a modified radical mastectomy for breast cancer

A

Modified radical mastectomy: The entire breast and several axillary lymph nodes are removed; the chest wall is left intact.

104
Q

what is external radiation for breast cancer

A

External radiation: A radiation therapy machine aims radiation toward the tumor. Treatments are given 5 days a week for 5 to 6 weeks.

105
Q

what is internal radiation for breast cancer

A

Internal radiation (mammo site): A radioactive substance sealed in needles, seeds, wires, or a catheter is placed directly into or near the tumor. Treatments are given twice a day for 5 days for a total of 10 sessions.

106
Q

what is post op care for breast cancer surgery

A

Precautions on affected side

–tubes/drains

107
Q

what are precautions to reduce risk of lymphedema

A
  • -Exercise as directed on the affected side
  • -Perform ADLS with affected side
  • -No lab draws or Blood Pressures on affected side
  • -Avoid Injury
  • -Avoid Infection
  • -Avoid Constriction/Tightness
  • -Avoid Muscle Strain
108
Q

what is the main cause of cervical cancer

A

HPV

–slow growing starts with cervical dysplasia

109
Q

what are risk factors for cervical cancer

A
  • -HPV
  • -Early Onset of Sexual Activity (<16)
  • -Cigarette Smoking
  • -Multiple Sex Partners
  • -STI’s – Genital Herpes, Chlamydia
  • -Weakened Immune System
110
Q

what are clinical manifestations of cervical cancer

A
  • -no sx during early stages
  • -Abnormal Vaginal Bleeding between Periods, After Intercourse, After Menopause
  • -dysparenuria
  • -appetite/weight loss
  • -pelvic/leg pain
  • -Vaginal Discharge (watery, pink, brown, bloody, foul-smelling)
111
Q

clinical manifestations of ovarian cancer

A
  • -Vague – Difficult to Diagnose
  • -Early Stages – Asymptomatic
  • -Abdominal & Pelvic Pressure/Pain
  • -Swollen, Bloated Abdomen
  • -Urinary Urgency/Frequency
  • -Difficulty Eating or Feeling Full Quickly
112
Q

what are risk factors for ovarian cancer

A
  • -Family History
  • -Age >55
  • -1st Term Pregnancy >35
  • -BRCA1, BRCA2 genes
  • -Personal History of Cancer
  • -Obesity
  • -Infertility Medication (>1 year)
113
Q

what is family planning

A

Family Planning: the conscious decision on when to conceive or avoid pregnancy throughout the reproductive years

114
Q

what is contraception

A

Contraception: Intentional prevention of pregnancy during sexual intercourse

115
Q

what is birth control

A

Birth Control: device or practice used to decrease the risk of conceiving or bearing offspring

116
Q

what are 4 roles of the nurse regarding contraception

A

Assess knowledge
Identify misconceptions
Provide education
Support

117
Q

what are 5 considerations when choosing contraception

A
  • -Reliability
  • -Cost
  • -Protection from STIs
  • -Individual’s comfort level with the method
  • -Partner’s willingness to use a particular method
118
Q

what are 5 methods of contraception

A 
Natural Methods
Barrier Methods
Hormonal Methods
Long-Acting Reversible Contraceptives
Sterilization
119
Q

what are 4 natural contraception methods

A

Barrier Methods
Hormonal Methods
Long-Acting Reversible Contraceptives
Sterilization

120
Q

what is abstinence

A

Refraining from sexual intercourse

–The only form of birth control that is 100% effective

121
Q

what is the fertility awareness method (FAM) for natural family planning

A

–calendar method, monitoring body functions (Temperature, Cervical Mucus: Color, Amount, Texture)

122
Q

what are advantages and disadvantages of FAM

A
  • -Advantages = No chemicals, easily available, aware of fertility
  • -Disadvantages = Does not protect against STI’s, Rigorous monitoring, 24% failure rate
123
Q

for natural family planning, how long to abstain from sex before and after ovulation (fertile period)

A

Abstain from intercourse for 4 days before and for 3-4 days after ovulation (fertile period)

124
Q

what is the amount of days between the beginning and the end of the fertile period of the menstrual cycle

A

~ 12-14 days before the next period

125
Q

what is the only acceptable contraception practice acceptable by the roman catholic church?

A

natural family planning

126
Q

how to calculate the start of the fertile period

A

Subtract 18 days from # of days in the shortest cycle

127
Q

how to calculate the end of the fertile period

A

Subtract 11 days from # days of the longest cycle

128
Q

what is basal body temperature and when to take

A

BBT is the lowest body temperature of a healthy person

–taken immediately after waking before getting out of bed

129
Q

during ovulation, what does basal temperature show

A

Basal temperature may show slight increase at time of ovulation (<0.5 F)

**Practice abstinence at this time

130
Q

what is the withdrawal method

A
  • -Coitus Interruptus
  • -Male partner withdraws his penis from the vagina before ejaculation occurs
  • -least effective method
131
Q

when is postpartum infertility and what causes this

A

less than 6 months from birth

–Increased levels of prolactin inhibits production & secretion of gonadotrophin releasing hormone, LH, & FSH

132
Q

what are the 5 barrier methods for contraception

A 
Condoms
Vaginal Sponges
Cervical Caps
Diaphragms
Spermicides
`
133
Q

what is the best barrier method of protection against STIs?

134
Q

what are disadvantages of condoms

A

allergy, may disrupt intercourse

135
Q

how long should vaginal sponges be left in after sex

A

6 hours, up to 30

136
Q

what is an advantage of a vaginal sponge

A

no fitting needed

137
Q

what is a disadvantage of a vaginal sponge

A

1x use only

138
Q

how long should a cervical cap be left in

A

6 hours, up to 48

139
Q

what are disadvantages of the cervical cap

A
  • -Spermicide

- -No protection against STIs

140
Q

what is the diaphragm for contraception

A

dome-shaped cup placed over the cervix

Used in combination with spermicide

141
Q

when does the diaphragm need to be refitted

A

after birth or large weight gain/loss

–annual gyn exam needed, should be replaced every 2 years and inspected before each use

142
Q

how long can you leave diaphragm in after sex

143
Q

what are disadvantages of the diaphragm

A
  • -May increase risk of yeast infection, cystitis, TSS – Toxic Shock Syndrome
  • -Must be fitted by a provider
  • -May increase infections, STIs
144
Q

what is spermicide

A

Chemical placed into the vagina before intercourse

145
Q

what is a disadvantage of spermicide

146
Q

what are hormonal methods of birth control

A
  • -OCP – Oral Contraceptive Pills
  • -Emergency Contraceptives
  • -Progestin Only – “Mini Pill”
  • -Depo-Provera
  • -Contraceptive Patch
  • -Vaginal Ring
147
Q

what is the oral contraceptive pill (OCP)

A

suppresses ovulation, combined estrogen & progestin

comes in =
28-day packs
21-day packs
91 day packs

148
Q

what 3 things does OCP do

A

Suppresses Ovulation
Thickens Cervical Mucus (blocks semen)
Alters Uterine Decidua

149
Q

if one OCP pill is missed, what to do

A

If 1 pill is missed – take as soon as possible
–If 2 or 3 pills are missed, follow manufacturer’s instructions and use alternate form of contraception or abstinence until next cycle

150
Q

what medications decrease the effectiveness of OCP pills

A

anticonvulsants

antibiotics

151
Q

what are contraindications for the OCP pill

A
  • -Hx: DVT, pulmonary emboli, hypertension, heart disease
  • -Women aged 35 or older, who smoke
  • -Active cancer
  • -Genetic clotting disorders, liver disease
152
Q

what are SEs of OCP

A

Nausea, Headaches, Spotting, Weight Gain, Breast Tenderness, Chloasma

–Increased risks for blood clots, heart disease, and strokes

153
Q

what is the ACHES serious complications of OCPs

A 
Abdominal pain
Chest pain
Headaches
Eye probs
Severe leg pain
154
Q

what is the POP or mini pill

A
  • -progestin only, NO estrogen
  • -1 pill/day
  • -can be used with lactation and does not affect the production of breastmilk
  • -less effective than combined OCPs
155
Q

what is an emergency contraceptive

A
  • -Postcoital ingestion of hormones
  • -Must take within 72 hours to prevent pregnancy
  • -Will not disturb an implanted pregnancy
  • -SE: headache, nausea, vomiting, abdominal pain
  • -Does not protect against STIs
156
Q

what is Depo-Provera

A

Injectable (IM) every 3 months (4xs/year) that supresses ovulation

  • -use every 11-13 weeks
  • -longer form of BC
157
Q

what are SEs of Depo-Provera

A

SE: weight gain, decreased bone density, delayed fertility, headaches, mood changes, breast tenderness

158
Q

what is the contraceptive patch

A

Ortho Evra

  • -Hormones are steadily delivered transdermal
  • -Estrogen & Progestin – stop ovulation
  • -Placement: Abdomen, Back, Butt
159
Q

when to change contraceptive patch

A

Change patch weekly x 3 weeks: remove for 1 week

160
Q

what meds decrease effectiveness of contraceptive patch

A
  • -Antibiotics

- -Anti-Seizure medications

161
Q

what can be used for depression and menopause that is herbal and will not decrease effectiveness of contraception patch

A

St. John’s Wart – Herbal Remedy

162
Q

what is the NuvaRing

A

vaginal contraceptive ring

  • -Hormones are released from a flexible ring inserted into the vagina
  • -delivers continuous levels of hormones for 3 weeks, replaced monthly
163
Q

What are long acting reversible contraceptives

A
  • -IUC – Intrauterine Contraceptives

- -Hormone Implants

164
Q

what is an IUD and 3 actions

A

–IUD is T shaped device

  • -Thickens cervical mucus
  • -thins uterine lining
  • -suppresses ovulation
165
Q

what is the benefit of a copper IUD

A

No hormones & 10 years

166
Q

what hormone released with Mirena (levonorgrestrel) IUD

A

Hormone: Progestin (no estrogen) & 3-5 years

167
Q

what is the risk of IUDs

A

Pregnancy risk – increased % ectopic pregnancy

168
Q

how is placement of an IUD verified

A

Strings protrude into vagina to verify placement

169
Q

what is PAINS to remember IUD complications

A
  • -Period Irregularities
  • -Abdominal Pain
  • -Infection
  • -Not Feeling Well – Malaise
  • -String Missing
170
Q

what is Nexplanon

A

hormone implant

  • -tiny thin rod in arm
  • -progestin only
  • -5 years
  • -quick return to ovulation post removal
171
Q

what are 3 surgeries for sterilization

A

Vasectomy
Tubal Ligation
Sterilization Implant

172
Q

what is bilateral tubal ligation

A

Uterine tubes are occluded

  • -general anethesia
  • -Only surgical removal of the ovaries (oophorectomy) or uterus (hysterectomy) or both will result in absolute sterility for a woman
173
Q

what is vasectomy and a consideration for contraception use after

A 
Sperm ducts (vas deferens) are occluded
--requires alt contraception until 2 post-surgery sperm tests indicate effectiveness
174
Q

what is a sterilization implant

A

Implant placed into Fallopian Tubes

–Creates scar tissue & blocks tubes

175
Q

how only do you have to be to have sterilization

Nursing (7 decks)

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