Reproductive Health Concerns Flashcards
STI’s - Reportable
Concern: using contraception to prevent pregnancy but not to prevent STI’s (OCP)
Transmission: blood and body fluids (oral, vaginal, anal, BF)
- Many STIs are incurable including: hep B, genital herpes, HPV & HIV
- Reportable (Gonorrhea, Syphilis, Chlamydia, HIV AIDS, Hep A, Hep B, Hep C
Prevention is Key
- include a risk-assessment as part of general health assessments
- when high-risk behaviours are identified, provide counseling on safer sex options
- Behaviour is driven by perceived risk
- If she/he doesnt believe there are serious consequences, she/he won’t change behaviour
Nursing Care STI:
- provide specific, unbiased information
- may be providing care to clients whose lifestyle behaviours do not match your own values; non-judgemental care
- Provide care in a private setting with open-ended discussion
- consider who else is in the room
- Need to “match client” in terms of level of language
- avoid “overly professional terms” & confirm patient’s understanding of what is sex
Assessing STI Risk Behaviour
How do you define “sexually active”?
Are you currently sexually active now?
No -> Have you had sex in the past?
With how many different people?
Have your partners been men, women or both?
Have you ever thought that a sex partner put you at risk for STI/HIV?
(e.g. IV drug user, bisexual)
Have you ever had a STI?
What do you do to protect yourself from HIV/STIs
Do you have any health problems you believe are affecting your sexual expression?
Have you ever had testing for a STI?
Do you have any worries or concerns about sex now?
Contraception
A contraceptive that is 100% safe, 100% effective, inexpensive, simple to use, readily available, totally reversible, not directly connected to the act of intercourse does not exist
Facts from SOGC
- nearly 1/3 of all Canadian sexually active women aged 15-44 yrs use the OCP
- condoms are used by only 21% of females
- 6% rely on the withdrawal method
- 21% have chosen sterilization
- 50% of all pregnancies in Canada every year are unintended % 75% of sexually active teens do not use protection regularly
Barriers to Access
Embarrassment
- doctor/public health nurse as “gatekeeper”
- having the cashier ring it through
Access issues
- rural communities where maybe 1 or 2 places to get it
Cost
- not covered by MSP
Privacy
- small town- “everyone know’s everyone”
- being seen going into Dr’s office
Barriers for Use
Not comfortable discussing it
- not a long-term relationship; “in the moment”
May not have it with you
- diaphragm; situation wasn’t planned
Consumption of alcohol, cannabis
Contraception Options
Hormonal Methods
Barrier Methods (putting up a wall)
Fertility Awareness Methods (understanding menstrual and ovulatory part of the cycle)
Sterilization
Implications of Use (Female Condom)
- Require high motivation
- Noisy
- May interfere with the maintenance of an erection
- May interfere with or interrupt foreplay
- May interfere with either partner’s enjoyment of intercourse
- May break or slip
- May have an unpleasant taste if used during oral sex
Spermicide
Nonoxynol-9
- discipline for foams, sponges, films. Need 15 min or > before ejaculation to work as directed
- not 100% effective against certain STIs
Diaphragm & Cervical Cap
Teaching for all women who rely upon either of these methods:
- potential risk of toxic shock syndrome - never use either during menstrual bleeding & up to 6 weeks postpartum
- women using these methods must remove 6-8 hrs post insertion
- Must be refitted after any gyne surgery, birth or major weight losses or gains
Hormonal Methods: oral contraceptive pills
One of the world’s most prescribed medications - approx 100 million women
different combinations of estrogen & progesterone available
- “the pill” is suitable for most healthy women and can be used long-term. Estrogen-based: CAUTION in women who smoke and are > 35 years
With proper use, the Pill is 99.9% effective, making it the most reliable contraception. Reality: 3% user failure rate
Benefits of Hormonal Birth Control
- in addition to being the most effective form of contraception, the Pill:
- regulates the menstrual cycle
- reduces menstrual flow
- can reduce the number of periods per year
- reduces acne
- protects against certain cancers
- is completely reversible
Must take OCP at the same time every day
if 1 is missed, take asap and continue, even if you end up taking two at the same time.
If 2 are missed, take both and use a supplementary form of contraception
If 3 or more are missed, follow algorish on next page.
Contraindications of OCP
those with personal hx of breast cancer, migraine with aura and seizure disorders, pregnancy and lactation, hypertension and DM Type 1 and 2
