1 - Contraception

Question 1

What is the one disadvantage of Abstinence?

Answer 1

self-control

otherwise, it is the best form of birth control

Question 2

What is Coitus Interruptus?

Answer 2

Man withdraws penis from vagina prior to ejaculation

Question 3

What is the most ineffective method of BC?

Answer 3

Coitus Interruptus

• monogoamous couples should be only ones who use b/c no protection against STIs

Question 4

A woman records her menstrual cycle by calculating her fertile period based on the assumption that ovulation occurs about 14 days before the onset of her next menstrual cycle, and avoids intercourse during that period.

Answer 4

Calendar Method

Question 5

How long are sperm viable?

How long is ovum viable?

Answer 5

sperm = 48-120 hr

ovum = 24 hr

Question 6

Client instructions for Calendar Method?

Answer 6

› Accurately record the number of days in each cycle counting from the first day of menses for a period of at least six cycles.

› The start of the fertile period is figured by subtracting 18 days from the number of days in the woman’s shortest cycle.

› The end of the fertile period is established by subtracting 11 days from the number of days of the longest cycle.

› Refrain from intercourse during these days to avoid conception.

Question 7

How do you determine end of fertile period when using calendar method?

Answer 7

Record # of days in each cycle for last 6 cycles

The end of the fertile period is established by subtracting 11 days from the number of days of the longest cycle.

For example:
» Shortest cycle, 26 – 18 = 8th day
» Longest cycle, 30 – 11 = 19th day
» Fertile period is days 8 through 19.

Question 8

Calendar Method is most useful when combined with—-

Answer 8

Most useful when combined with basal body temperature or cervical mucusmethod

Question 9

What is Basal Body Temperature method?

Answer 9

Temperature can drop slightly at the time of ovulation. This can be used to facilitate conception, or be used as a natural contraceptive.

*****measure temp prior to getting out of bed each morning

Question 10

What is another name for the Cervical Mucus method?

Answer 10

Symptom-Based Method

› Fertility awareness method based on ovulation. Ovulation occurs approximately 14 days prior to the next menstrual cycle, which is when a woman is fertile. Following ovulation, the cervical mucus becomes thin and flexible under the influence of estrogen and progesterone to allow for sperm viability and motility. The ability for the mucus to stretch between the fingers is greatest during ovulation. This is referred to as spinnbarkeit sign.

Question 11

Spinnbarkeit Sign

Answer 11

ability of mucus to stretch, which is greatest during ovulation

Question 12

What are the Natural Family Planning contraceptive plans?

Answer 12

Abstinence

Coitus Interruptus

Calendar Method

Basal Body Temp

Symptom-Based Method (Cervical Mucus)

Question 13

What are the Barrier Methods to Contraceptives?

Answer 13

Condoms

Diaphragm and Spermicide

Question 14

What are the Hormonal Methods to Contracetives?

Answer 14

Combined Oral Contraceptives

Minipill

Emergency Oral Contraceptive

Transdermal Contraceptive Patch

Injectable Progestins (Depo-Provera)

Contraceptive Vaginal Ring (Nuvaring)

Implantable Progestins Etonogestrel (Implanon)

Intrauterine Device (IUD)

Question 15

A dome-shaped cup with a flexible rim made of latex or silicone that fits snugly over the cervix with spermicidal cream or gel placed into the dome and around the rim.

Answer 15

Diaphragm and Spermicide

Question 16

Client Instructions for Diaphragm

Answer 16

Must be refitted q 2 yrs

Must be refitted if 7kg weight change, full-term pregnancy, or 2nd term abortion

Empty bladder prior to insertion

Inserted prior to coitus

Question 17

Clients who have a history of —- cannot use a diaphragm

Answer 17

TSS (Toxic Shock Syndrome)

**caused by bacterial infection

Question 18

Hormonal contraception containing estrogen and progestin, which acts by suppressing ovulation, thickening the cervical mucus to block semen, and altering the uterine decidua to prevent implantation.

Answer 18

Combined Oral Contraceptives

Question 19

Contraindications for oral contraceptives

Answer 19

Blood Clots

Stroke

Cardiac Problems

Breast (or Estrogen related) Cancers

Pregnancy

Smoking (if over 35 yrs old)

Question 20

Which has fewer S/E: Minipill or Combined Oral Contraceptives

Answer 20

Minipill has fewer S/E

***both have the same action

Question 21

Which contraceptive causes breakthrough, irregular, vaginal bleeding and decreased libido?

Answer 21

Minipill

Question 22

— can be obtained w/out prescription by women 17 and younger.

Answer 22

Emergency Oral Contraceptive

Question 23

S/E of which Contraceptive Method:

Nausea, heavier than normal menstrual bleeding, lower abdominal pain, fatigue, and headache

Answer 23

Emergency Oral Contraceptive

Question 24

When is the patch applied?

Answer 24

Patch is applied the same day of the week for 3 weeks with no application of the patch on the fourth week.

Question 25

Why is liver metabolism NOT a problem w/ Transdermal Patch?

Answer 25

Avoids liver metabolism of medication because it is not absorbed in the gastrointestinal tract.

Question 26

How often is the Injectable Progestin shot given?

Answer 26

IM injection every 11-13 weeks

** 4 x’s a year

Question 27

A nurse in a health clinic is reviewing contraceptive use with a group of adolescent clients. Which of the following statements by an adolescent requires clarification?

A. “A water-soluble lubricant should be used with condoms.”

B. “Spermicide is applied once when using a diaphragm.”

C. “Oral contraceptives can improve a case of acne.”

D. “A contraceptive patch is worn for a week.”

Answer 27

B. “Spermicide is applied once when using a diaphragm.”

Spermicide should be applied with each act of coitus.

Question 28

A nurse is instructing a client who has been prescribed oral contraceptives about danger signs. The nurse evaluates that the client understands the teaching regarding side effects when she states the need to report

A. reduced menstrual flow or amenorrhea.

B. weight gain or breast tenderness.

C. chest pain or shortness of breath.

D. mild hypertension or headaches.

Answer 28

C. CORRECT:

Chest pain or shortness of breath may indicate a pulmonary embolus or myocardialinfarction.

Question 29

A nurse in an obstetrical clinic is providing education about contraception to a 21-year-old client. Which of the following statements by the client requesting information regarding an IUD indicates a need for additional teaching?

A. “An IUD may increase my risk for an ectopic pregnancy.”

B. “I will wait until I have a child before I can have an IUD.”

C. “I might have irregular bleeding after I get an IUD.”

D. “A change in the string length of my IUD is expected.”

Answer 29

D. CORRECT:

A change in the length of the string of an IUD may indicate expulsion and should be reported to the provider.

Question 30

A nurse in a clinic is teaching a client about her new prescription for medroxyprogesterone (Depo-Provera). Which of the following should be included in the teaching?

A. “Weight loss can occur.”
B. “You are protected against STIs.”
C. “You should be taking calcium also.”
D. “You should avoid taking antibiotics when using this contraceptive.”

Answer 30

C. CORRECT: Clients should take calcium and vitamin D to prevent loss of bone density, which can occur when taking Depo-Provera.

Question 31

Which of the following should the nurse include when teaching a client about the potential disadvantages of the minipill? (Select all that apply.)

   A. Amenorrhea 
   B. Irregular vaginal bleeding
   C. Increased appetite
   D. Decreased libido
   E. Ovarian cysts

Answer 31

B. CORRECT: Irregular vaginal bleeding is a disadvantage of the minipill.

C. CORRECT: Increased appetite is a disadvantage of the minipill.

D. CORRECT: Decreased libido is a disadvantage of the minipill.

E. CORRECT: The increased occurrence of ovarian cysts is a disadvantage of the minipill.