Reproductive Health and Family Planning Flashcards
Contraceptive
intentional prevention of pregnancy during sexual intercourse
Birth Control
the device or practice to decrease the risk of conceiving or bearing offspring
Family Planning
the conscious decision on when to conceive or avoid pregnancy throughout reproductive years
What is the risk of 85+ taking hormonal contraception ?
higher rates of developing blood clots
What is Coitus Interruptus and the pros/cons ?
pull out before ejaculation
- P: no cost and side effects, latex allergy friendly
- C: no protection against STD or HIV
What is Fertility Awareness Methods (FAMS) and the cons ?
identifies fertile periods of the menstrual cycle & avoids intercourse during these periods
- C: higher failure rate with people who don’t have a mentor that guides them on this & partner willingness
What are the different types of FAMs ?
- natural family planning
- basal body temperature (BBT)
- breastfeeding
- mucus detection method
What is basal body temperature and how does it work ?
- temperature will drop prior to ovulation
- measure oral temp prior to getting out of bed each day
- inexpensive and convenient
- have to have a very sensitive thermometer
- affected by illness, alcohol, anxiety, <3 hrs sleep
What is cervical mucus ovulation detection method and how does it work ?
- fertility awareness based on observing cervical mucous to determine ovulation
- mucous that is thick means they aren’t fertile and when mucous is more watery and less acidic than that means they are fertile
- Mucous becomes thin and watery under influence of estrogen and progesterone allowing for sperm viability and motility
- not reliable
- Spinnbarkeit Sign
What is Spinnbarkeit sign ?
mucus’s ability to stretch between the fingers at time of ovulation
How is Breastfeeding a contraception ?
as infant breastfeeds, Prolactin is released which acts as a contraception
- hormonal contraception
- cons: only for about 6 months before baby eats solid food
- Lactational Amenorrhea Method
- no less than 4 hours during the day and 6 hours at night (ideal feeding intervals)
What is spermicide and the cons ?
nonoxynol-9 reduces sperms mobility by attacking flagella and body of sperm
- higher risk of HIVbecause of breakdown of epithelial lining of vaginal canal
- no evidence that adding spermicide to condoms will decrease pregnancy
What are examples of barrier methods of contraceptives ?
- spermicide
- condoms
- diaphragm
- sponge
- copper intrauterine device
- hormonal levonorgestrel intrauterine system
What are some examples of hormonal contraceptives ?
- breastfeeding
- combination oral contraceptives
- contraceptive ring
- contraceptive patch
- injectable progesterone
- implantable progestin
- emergency contraception
- hormonal levonorgestrel intrauterine system
What are condoms and risks/benefits ?
thin, flexible sheath worn on penis during intercourse to prevent semen from entering uterus
- protects against STIs & HIV
- only use water-soluble lubricants as oil-based lubricants can break down condom
- Cons: incorrect placement, breakage overtime
What is a Diaphragm and how does it work ?
shallow, dome-shaped device with flexible rim that covers cervix
- hormone free method but recommended with spermicide
- must be fitted by health care provider as each cervix placement is unique to each woman
- put in right before or up to 6 hours before intercourse, leave in for at least 6 hours after
- can cause UTIs so empty bladder before
- if you have weight gain/loss or pregnancy then you must get fitted again
- assess fit yearly
What is the contraceptive sponge and how does it work ?
sponge that contains N-p spermicide and is designed to fit over the cervix
- moisten with water before insert
- should be left in place for 6 hours after intercourse to get sperm a chance to go away
- removed by 24 hours
- failure rate is greater than diaphragm
- not reusable
What are oral contraceptives and how do they work ?
combined estrogen-progestin contraceptives (COCs)
- inhibits follicle maturation & ovulation
- endometrium lining is altered, making implantation difficult
- should be taken every day at the same time
- Cons: weight gain, increased symptoms of depression and anxiety
What are the Risks and Benefits of COCs ?
Risks:
- increase chance of DVT, stroke or embolism
- decrease milk supply
- chloasma, oily skin
- can increase BP, MI, and liver functions
- gallbladder problems
Benefits:
- decreased blood flow & regulation of cycles
- improves symptoms of PMS
- less ovarian/uterine cysts
- protection against endometrial & ovarian cancer
- improved acne
What are some people we won’t recommend COCs for ?
- smokers > 35 yrs old
- breast cancer
- pregnancy
- diabetes mellitus greater than > 20 years
- HTN
- history of CV or CAD
- vascular disease
- lactation lass than 6 weeks
- headaches with neurological symptoms (at higher risk for stroke)
What happens to fertility with COCs ?
- once stopped fertility usually returns quickly (around 3 months)
- might be slightly lower the first 3-12 months after stopping (especially if they’ve been on COCs for a long time
How does the vaginal contraceptive ring work ?
placed in vagina that secretes estrogen and progesterone
- bypassed liver for metabolism
- leave in for 3 weeks and out for 1
- hormonal
How does the transdermal contraceptive system patch work ?
patch placed on skin for 1 week, change it out every week and rotate site of application then off for 1 week
- higher failure rate if you weigh over 198 pounds (need to adjust drug amount on patch)
- hormonal
What is the injectable progesterone called ?
Depo-Provera
How does the Depo-Provera work ?
- Progesterone only injection (deltoid or gluteus maximus) every 11-13 weeks
- hormonal
- good option for breastfeeding mothers
- “long-term” method
- lactation is less likely to be affected by progesterone only contraceptives
- can take up to 18 months for fertility to resume
What are some side effects of the injectable progesterone ?
irregular spotting, increased weight gain, decreased libido, breast changes, decreased bone mineral density, risk of DVT
What is the implantable progestin ?
- single rod implant
- injected subdermally on non-dominant arm
- prevents some ovulatory cycles & thickens cervical mucous
- does not affect lactation
- good for 3 years
- hormonal
What are some side effects of the implantable progestin ?
- irregular bleeding
- headaches
- nausea
- skin changes
- vertigo and nervousness
What is emergency contraception ?
offers protection against pregnancy for up to 120 hours after unprotected intercourse
- ideal time= < 72 hours
- inhibits follicular development
- not an abortion pill because it has to be used before the egg fertilizes and implanted (won’t be effective if this has occurred already)
- Cons: nausea or bleeding, can take antiemetic 1 hour before
How does the Hormonal Levonorgestrel Intrauterine System work ?
effective 3-7 years
- impairs sperm motility, irritates uterine lining & anovulatory effects
- causes irregular spotting
- hormonal and barrier
How does the copper intrauterine device (paraguard) work ?
copper acts as spermicide and inflames endometrium
- effective up to 12 years
- only barrier
- cons: increased bleeding and cramping, can be painful
What are some risks of IUDs ?
IUDs can increase pelvic inflammatory disease (PID) within 20 days of insertion and uterine perforation
- check for the 2 strings that hang from the base stem through the cervix and protrude into the vagina for the woman to feel for assurance of placement
- remove immediately if pregnancy is suspected
What is permanent sterilization work for women and the risks?
tubal ligation
- laparoscopic procedure to occlude (close) tube
- still have a period but seek medical care if you suspect pregnancy
- HIGH risk for ectopic pregnancy
- no protection against STIs and HIV
How does male sterilization work ?
vasectomy
- sealing, tying or cutting of the vas deferens
- can be reversed
- must have 2 consecutive sperm counts of zero to be considered infertile
- complications such as pain, bleeding and infection can occur, most complications are minor
Family
primary unit of socialization and basic structural unit within a community
What is the difference between family and family dynamics ?
family dynamics is interrelationships between and among individual family members or the force at work within a family that produce particular behaviors or symptoms
What is Family Systems Theory ?
Wright & Leahy
- nurses view family as a unit and focus on observing the family interactions vs. individually
- change in one family member affects the whole family
- family as a whole is greater than the sum of the individuals
- family able to create balance between change and stabilitu
What is the Structural-Functional Theory ?
family is a social system and each member has a specific role
- doesn’t focus much on if someone can’t do their role and what happens
What is Family Stress Theory ?
the way a family reacts to internal and external contexts of stress
What is Family Life Cycle Theory ?
relationships between family members pass through stages depending on developmental stresses
What does Calgary’s Family Assessment Model look like ?
Structural
- members of family, relationships and context of the family
Developmental
- considers concurrent development of individuals within the family
Functional
- addresses how family members behave in relation to one another
- Instrumental: family activities of day-to-day living
- Expressive: communication, problem solving, power, values, beliefs
Family Cohesion
emotional bonding between family members
What is a Ecomap ?
a genogram
Family Coping
actions that manage stressors
Family Disorganization
loss of social controls that can lead to negative family dynamics
Family Functioning
the capacity of the family to meet the needs of family members
Culture
shared values and beliefs of the family
What is Indiana’s intimate partner violence laws like ?
Indiana isn’t an automatic report state where someone over the age of 18 has to be reported for
- if under the age of 18 then it must be reported
What is Confidentiality in IPV (intimate partner violence)?
always see patient alone for every visit so that you can bring up relationship violence safety
- be nonjudgmental
- listen
- offer info and support
- don’t push for disclosure
What is Support in IPV ?
know how to support someone who discloses violence
- offer a care plan and safety plan
- makes a warm referral to local domestic/sexual violence partner agency
How are adolescents different with IPV ?
- many times they don’t have much experiences with partners
- may not realize partner violence is occuring
- ask questions like,” does your partner shame you or make you feel stupid, threaten you with embarrassing you so that they can control you” ?
What are some important things to keep in mind when screening patients for violence ?
- be patient
- don’t be in a rush
- be willing to listen and give your full attention
- may have to get creative on how to separate the person experiencing the violence and the aggressor
How will a secure baby act when separated from caregiver ?
they will cry and want to be reunited and when they are reunited they stop crying and
How will an avoidant baby act when separated from caregiver ?
they will show no signs of distress or want to be reunited
- due to lack of trust with caregiver
- can lead to a dismissive adult who will do well in situation that don’t demand interpersonal connection
How will an Ambivalent baby act when separated from caregiver ?
will cry and want to be reunited and when parent comes back they will still cry and may push away from parent
What is a family ?
primary unity of socialization and basic structural unit within a community
