OB--EXAM 1 Flashcards

1
Q

♣ The core concept of women and family center care are:

A
  • Dignity
  • Respect
  • Information sharing
  • Participation
  • Collaboration
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2
Q

♣ Nurses need to remember that _____ _____ is a key part in effective communication

A

active listening

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3
Q

• your way is the best way

A

ethnocentrism

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4
Q

When a person learns about the client’s preferences and their beliefs, a plan of care needs to be made by both the nurse or the family and the nurse and they need to work out certain things that the family is adamant about

A

Cultural relativism

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5
Q

♣ is a skill.
It involves respecting the differences others may have regarding religion, ethnicity, and ethno culture.

encourages uniqueness and values every culture

A

cultural competence

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6
Q

o care for the elderly or the infirm

A

medicare

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7
Q

aid for the poverty or situational crisis

A

medicaid

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8
Q

The priority in a home visit is to

A

obtain information that helps to create a comprehensive client profile

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9
Q

home visit usually lasts

A

1 hour

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10
Q

the 2 most important components of home care.

A

Safety and infection control

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11
Q

♣ The nurse should regard their personal safety as

A

priority number one.

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12
Q

what approach in well woman care

A

holistic

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13
Q

o Includes health needs throughout lifetime

A

well woman care

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14
Q

o OBGYN for needs as women age

A

physical exams

age-appropriate screenings

health promotion

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15
Q

o Usually enter for care 1st for

A

pap test or use of contraceptives.

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16
Q

spacing btwn pregnancies

A

18-23 months

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17
Q

o Usually one of the main reasons that a woman would seek treatment

A

menstrual problems

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18
Q

o This is seeking care prior to a pregnancy

A

preconception counseling and care

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19
Q

• If the mom is drinking during pregnancy,____ may occur.

A

Fetal Alcohol Syndrome

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20
Q

if mom smokes

A

low birth weight babies

babies addicted to nicotine

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21
Q

caffeine restriction should be

A

200 ml per day

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22
Q

fetal organ development occurs how many days after fertilization

A

17-56

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23
Q

o It is recommended that prenatal care be obtained within

A

12 weeks.

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24
Q

goals of prenatal counseling

A

o determining health status of mother and fetus

o Calculate the gestational age

Monitor fetal development

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25
Q

o Once infertility has been diagnosed

A

refer mom to specialist

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26
Q

o The transitional period to menopause

A

perimenopause

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27
Q

why do women seek treatment for perimenopause

A

hot flashes

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28
Q

why do women get hot flashes?

A

decrease in estrogen

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29
Q

♣ Babies of teens can be at risk because

A

teenage moms are not as prepared to take care of the baby.

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30
Q

♣ Women past the age of 35: can be more susceptible to

A

developing diabetes and having babies with Down syndrome.

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31
Q

black women

A

sickle cell anemia

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32
Q

women btwn ____ can be more susceptible to alcohol issues

A

21-34

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33
Q

how much folic acid

A

0.4 mg

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34
Q

food with folic acid

A

green leafy veggies
whole grains
fruits

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35
Q

when to start folic acid

A

8 weeks into PG

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36
Q

which method gives you 100% protection against STDs

A

none

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37
Q

o Directly linked to STDs

A
♣	Infertility
♣	Ectopic pregnancy
♣	Neonatal death
♣	Genital cancers
♣	AIDS
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38
Q

o These conditions may develop during pregnancy and can cause harm to the woman and unborn baby.

A

♣ Diabetes
♣ Hypertensive disorders
♣ Seizure disorders

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39
Q

o can cause miscarriage, preterm labor, or problems with fetus.

♣ Can cause infertility

A

Pelvic inflammatory disesase & endometriosis

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40
Q

o Other conditions could cause miscarriage, preterm labor or problems with the fetus

A

♣ Incompetent cervix
♣ Bleeding disorders
♣ Uterine fibroids
♣ Abnormalities of the uterus.

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41
Q

♣ Toxoplasmosis can occur when

A

eating raw or rare meat

handles feces of the cat

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42
Q

♣ Normally the target of the violence is the ______ so bleeding is a health risk.

A

abdomen

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43
Q

o The problem is greater than statistics show because it is often

A

unrecorded.

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44
Q

how to ask women you think has been abused why they came in?

A

o “what brings you here today”?

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45
Q

• Pelvic examination during pregnancy

A

o Pap test at first prenatal visit

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46
Q

o A pap smear will not be done if the hysterectomy was done _______.

A

for a benign disease.

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47
Q

mammograms when?

A

annually after 40

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48
Q

o After age 50 they start screening for

A

bone density.

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49
Q

o Microscopic test for cancer cells

A

Papanicolaou (Pap) test

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50
Q

Papanicolaou (Pap) test obtains cell from

A

cervis
endocervix
mucous membranes

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51
Q

what to instruct women before Papanicolaou (Pap) test

A

don’t douche

use vag medications

or has sex 24-48 hours prior to exam

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52
Q

o The cycle of violence – 3 phases

A
  • Tension building
  • Battery
  • Honeymoon period where the man would be very loving, and kind.
  • (Today we no longer use this model because it is not thought to be accurate as to exactly what is happening).
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53
Q

♣ Women who survive these beatings often meet the criteria for _____

A

PTSD

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54
Q

Most homicide occurs once the woman

A

actually leaves the home.

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55
Q

♣ This is often a time when abuse starts due to the stress

A

pregnancy

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56
Q

♣ Maternal complications that come from abuse

A
  • Depression
  • Suicide
  • Infections
  • May turn to substances
  • Secondary symptoms such as fatigue
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57
Q

ABCDES

A
alone
belief
confidentiality
document
education
safety
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58
Q

a broad term that describes many forms of sexual abuse.

A

sexual violence

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59
Q

the intentional, unwanted, completed or attempted, touching the genitalia of another person.

A

sexual assault

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60
Q

a legal term, this is used for forced sexual intercourse, or penetration of the mouth, anus or vagina or even a body part, anything that gets penetrated without the woman’s permission.

A

rape

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61
Q

___% of college women said they were raped at some point in their college career.

A

25

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62
Q

o this consists of non-coitus sexual activity between a child and an adolescent or an adult.

A

molestations

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63
Q

o involves the penetration involved in rape to a person 18 or over to a person under the age of consent. The age of consent varies from state to state.

A

statutory rape

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64
Q

o Why do men rape?

risk factors?

A
  • Raped or molested as a child
  • Abused some other way when they were a child
  • Been raised to see women as sexual objects
  • May have been raised to see women in a hostile way
  • May think that the way a woman is dressed is asking to be raped
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65
Q

♣ Three phases of rape trauma victims

A

acute phase

outward adjustment phase

long-term process: reorganization

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66
Q

when the rape occurs, this phase starts. It can last for several days – up to three weeks. The woman will be in shock, denial, she will be in a state of disbelief. She might feel embarrassed, degraded, angry, fearful and vengeful. She might want to douche or shower to wash away the evidence.

A

acute phase

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67
Q

• Will look like she has recovered from the event. Might go back to work, continue normal routines. She will probably either buy a weapon, self-defense classes, install an alarm system. She also may not stop talking about the rape at this point, or she may not talk about it at all at this point. She may make radical changes, quit her job, move out of her house, may never want to step out of the house or be alone. She can develop sexual problems where she sees sex as something she does not want.

A

outward adjustment phase

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68
Q

• When she becomes depressed and anxious. She will discuss the rape one on one with someone at this point; she loses that denial and fear of being alone or in a crowd. She may develop nightmares and eating disorders. Recovery from a rape can take years and it is a very painful process. She no longer blames herself in this phase. These phases can also fluctuate back and forth.

A

reorganization

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69
Q
  • Absence of menstrual flow

* Often a result of pregnancy

A

amenorrhea

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70
Q

two categories of amenorrhea

A

primary & secondary

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71
Q

♣ Absence of menses by age 14 with absence of growth and development of secondary sexual characteristics

A

primary amenorrhea

72
Q

♣ Absence of menses by age 16 but normal development of secondary sexual characteristics

A

primary amenorrhea

73
Q

98% of girls menstruate by age ?

A

16

74
Q

causes of primary amenorrhea

A
•	Extreme weight gain or loss
•	Congenital abnormalities of reproductive system 
•	Stress
•	Excessive exercise
•	Hypothyroidism 
PCOS
type 1 DM
eating disorders
75
Q

♣ Absence of menses for 3-6 months in women who have previously menstruated regularly

A

secondary amenorrhea

76
Q

causes of secondary amenorrhea

A
  • Pregnancy – most common cause
  • Breast feeding
  • Emotional stress
  • Depression
  • Pituitary and endocrine d/o
  • Early menopause
77
Q

management for secondary amenorrhea

A
  • Oral contraceptives
  • Nutrition counseling
  • Thyroid hormone replacement
  • Other tx for underlying d/o
78
Q
  • painful menstruation
  • Pain during or shortly before menstruation
  • Cyclic perimenopausal pain
  • Most common gynecologic problem in women of all ages
  • Uterine contractions during all menstrual cycles; more intense/frequent.
A

dysmenorrhea

79
Q

Abnormally increased uterine activity – cramps more frequent and intense

Not caused by underlying pathology

A

primary dysmenorrhea

80
Q

♣ Increased _____ production by endometrium in ovulatory cycle in primary dysmenorrhea

A

prostaglandin

81
Q

prostaglandin levels are highest when in primary dysmenorrhea?

A

1st 2 days of menses

82
Q

♣ Usually appears within 6-12 months after menarche when ovulation is established

A

primary dysmenorrhea

83
Q

meds to treat primary dysmenorrhea

A

NSAIDs
ibuprofen
naproxen

84
Q

why do these meds work at treating primary dysmenorrhea?

A

it decreases the prostaglandin production

85
Q

♣ Acquired menstrual pain

Painful menstruation

A

secondary dysmenorrhea

86
Q

secondary dysmenorrhea is due to?

A

♣ due to pelvic or uterine pathology

87
Q

when does secondary dysmenorrhea develop?

A

later than primary– after age 25

88
Q

♣ Average age or a girl starting menstruation

A

11-13 years.

89
Q

♣ – the most common cause of secondary amenorrhea, fibroids, pelvic infection (PID), use of an IUD

pain beyond menstruation

A

endometriosis

90
Q

managing dysmenorrhea

A
  1. exercise
  2. limit salts to prevent fluid retention
  3. increase water for diuretic
  4. increase fiber
  5. warm showers or heating pads
  6. take warm showers
  7. keep legs elevated
  8. relaxation
  9. smoking cessation
  10. used prostaglandin inhibitors
91
Q

• Cyclic symptoms occurring in luteal phase of menstrual cycle; usually resolve once menses started

A

PMS

92
Q

symptoms of PMS

A
  • Abdominal bloating
  • Pelvic fullness
  • Breast tenderness
  • Weight gain
93
Q

♣ Emotional or behavioral changes

A
  • Depression
  • Crying spells
  • Irritability
  • Premenstrual cravings
  • Headache
  • Fatigue
  • Backache
94
Q

♣ More severe variation of PMS

A

o PMDD: (pre-menstrual dysphoric disorder)

95
Q

sx of PMDD

A
  • Mood changes/disturbances (more severe w/ PMDD)
  • Anxiety and fatigue
  • Appetite changes
  • General sense of feeling overwhelmed
  • These often occur during the luteal phase and have more of an emphasis on mood disturbances.
96
Q

PMDD affects what % of women

A

3-8

97
Q

♣ Will affect her ability to function
• Work related issues
• Interpersonal issues

A

PMDD

98
Q
•	Presence and growth of endometrial tissue outside of the uterus cavity:
o	Ovaries
o	Fallopian tubes
o	Outer surface of uterus
o	Bowels
o	Areas between vagina and rectum
A

endometriosis

99
Q

sx of emdometriosis

A
o	Dysmenorrhea
o	Pelvic pain
o	Dyspareunia (painful intercourse)
o	Abnormal menstrual bleeding
o	May have problems with infertility
100
Q

o tx of endometriosis with Women with mild pain wishing a future pregnancy

A

NSAIDs

101
Q

o tx of endometriosis with Women with moderate to severe pain

A

♣ Treated with continual use of the birth control pill. (shrink endometrial tissue)

102
Q

tx of endometriosis Women who do not wish to become pregnancy with severe pain

A

hysterectomy

103
Q

o Intermenstural bleeding

or bleeding after menopause

A

metrorrhagia

104
Q

causes of metorrhagia

A
BC pill
IUD
trauma
polyps
infection
ovarian cysts
105
Q

o Excessive menstrual bleeding in either the duration or amount

A

menorrhagia (hypermenorrhea)

106
Q

causes of menorrhagia

A
infection
IUD 
fibroids
polyps
CA
107
Q

treatment of menorrhagia

A

BC pill

fibroids surgically removed

108
Q

menopause age?

A

late 40s-50s

109
Q

median age for menopause

A

51-52

110
Q

• The absence of your menstrual period for one year

A

menopause

111
Q
  • A period that encompasses transition from normal cycles to cessation of menses
  • Marked by irregular menstrual cycles
A

perimenopause

112
Q

sx of perimenopause

A

hot flashes
night sweats
sleep disturbances

113
Q

tx of perimenopause

A
8 hrs of sleep
balanced diet
exercise
no caffeine, smoking, or alcohol
use of herbals
acupuncture
biofeedback
hypnosis
hormone therapy
114
Q

• Marked by irregular menstrual cycles

A

osteoporosis

115
Q

♣ Drop in _____ causes an imbalance between bone formation and resorption and causes a decrease in calcium absorption.

A

estrogen

116
Q

who’s at risk for osteoporosis

A

post menopausal white women

117
Q

most common areas of the body affected by osteoporosis

A

vertebrae & hip

118
Q

sx of osteoporosis

A

back pain
height loss
stooped posture

119
Q

tx of osteoporosis

A

increase calcium in diet

weight bearing exercises

estrogen receptor modulator

120
Q

menopausal hormonal therapy

A

ERT & HRT

121
Q

HRT

A

Hormonal replacement therapy

122
Q

Which hormones for HRT

A

♣ both estrogen and progestins

123
Q

if pt still has the uterus

A

5 year treatment with estrogen and progesterone

124
Q

NO uterus

A

only estrogen

125
Q

o The intentional prevention of pregnancy during sexual intercourse.

A

contraception

126
Q

o The device and/or practice to decrease the risk of conceiving, or bearing offspring.

A

birth control

127
Q

o The conscious decision on when to conceive, or to avoid pregnancy, throughout the reproductive years.

A

family planning

128
Q

BRAIDED informed consent

A
benefits
risks
alternatives
inquiries and questions
decisions may change mind
explanations
documentation
129
Q

o Look at the advantages and success rate

A

benefits

130
Q

o Information about disadvantages and failure rates

A

risks

131
Q

o Information about other methods

A

alternatives

132
Q

o Answer any questions she may have

A

inquiries and questions

133
Q

o The opportunity to work with the woman so she can make the best decision

A

decisions may change mind

134
Q

o Information about the particular method and how it’s used

A

explanation

135
Q

o The information given to the client as well as her understanding on how to use

A

documentation

136
Q

• “pull out method”

A

coitus interruptus

137
Q

o Combo of charting s/sx of menstrual cycle with abstinence or contraceptive methods during fertile period.

A

fertility awareness based methods

138
Q

o Periodic abstinence

A

natural family planning

139
Q

how to tell when you’re ovulating

A

lutenizing hormone surge in urine 12-24 hours after

140
Q

♣ Based on monitoring and recording cervical secretions
♣ Woman needs to assess whether or not she noticed cervical secretions today or yesterday and then avoid sexual intercourse or use backup method of BC
♣ If no secretions – the probability of pregnancy is low

A

two day method

141
Q

♣ Known as the “Billings Method”
♣ Relies on a woman being able to look at cervical mucus
♣ She needs to check and watch for stretch mucus which indicates her period of maximum fertility because the sperm can stay in this mucus until ovulation
♣ Avoid intercourse for 4 days after estrogen dominant mucus is apparent.

A

ovulation method

142
Q

♣ A woman will take temp every morning before she gets up – nothing to eat or drink before
♣ She needs to use a basal thermometer which is more accurate

A

body temperature method

143
Q

temp before ovulation

A

96-98 F

144
Q

• popular also as a protective measure against spread of STDs

A

spermicides and barrier methods

145
Q

o Chemical barriers may reduce the risk of some STDs but are not effective against

A

chlamydia, gonorrhea or HIV

146
Q

♣ A physical barrier that has a chemical action on the sperm

♣ Effectiveness in preventing pregnancy depends on its consistent and accurate use

A

spermicide

147
Q

when should spermicide be inserted?

A

no sooner than 1 hour before

148
Q

♣ Mostly latex and they do provide protection against STDs

Should be used with water based or silicone lubricants

A

condoms

149
Q

With the increase of latex allergies, condoms are not being made out of _______ – thinner and stronger than latex – research has been done

A

polyurethane

150
Q
  • Inserted up to 8 hours before sex – expensive

* This is if the male does not want to use a condom

A

female condom

151
Q

what to educate your patient about female condoms

A

don’t use it with a male condom because it could rip

152
Q

♣ Covers the cervix preventing sperm from entering

A

diaphragm

153
Q

what do you use with diaphragm

A

spermicidal jelly or cream

154
Q

when do you need to get the diaphragm refitted?

A

after pregnancy or a 15lb weight fluctuation

155
Q

when should diaphragm be inserted and removed?

A

up to 6 hours prior to intercourse and left in place for 6 hours after

156
Q

♣ Additional _____ should be used with each active intercourse when using the diaphragm

A

spermicide

157
Q

♣ Usually a good choice for women who are lactating and women who cannot or chose not to take the birth control pill and also for older women who smoke

A

diaphragm

158
Q

how to reduce the risk of toxic shock syndrome with use of the diaphragm?

A

remove it 6-8 hours after sex

don’t use it during menses

make them aware of s/sx of TTS

159
Q

♣ Similar to the diaphragm in effectiveness and insertion
♣ Fit snugly over the cervix
♣ Held in place by suction

A

cervical cap

160
Q

do you need to add additional spermicide with the cervical cap?

A

NOOOO

161
Q

♣ This may be left in place for up to 48 hours but then should be removed after intercourse

A

cervical cap

162
Q

♣ Must be moistened before inserting
♣ These will provide protection for up to 24 hours and numerous instances of intercourse
♣ Also be left in place for at least 6 hours after intercourse

A

contraceptive sponge

163
Q

♣ Available in over 30 different hormonal variations

suppresses ovulation

A

combined estrogen-progestin (the pill)

164
Q

who can use the pill

A

non-smoking women until menopause

165
Q

advantages of the pill

A

♣ Very effective
♣ Not associated with the act of intercourse
♣ Its controlled by the woman
♣ Very easy and convenient to take the pill
♣ Usually you will see a rapid return to fertility once the pill has been discontinued
♣ A safe form of birth control for older non-smoking women

166
Q

o Non-contraceptive benefits:

A

♣ Improvement in a woman’s menstrual characteristics

♣ Offered protection against endometrial cancer

♣ Protection against ovarian cancer

♣ Reduces the incidence of benign breast disease

♣ Improve acne in women

♣ Lowers the rates of ovarian cysts

♣ Helps treat endometriosis

♣ Decrease the risk of ectopic pregnancies

167
Q

o Disadvantages of the pill

A

♣ Must remember to take it everyday
♣ Cannot be taken while women are breast feeding because it will interfere with milk production
♣ No protection against STDs

168
Q

side effects of the pill

A
nausea
headache
fluid retentition
weight gain
breast tenderness
169
Q

why can’t smoking women take BC pill

A

blood clots

170
Q

emergency contraception must be used when?

A

42 hours to 3 days after unprotected sex

171
Q

3 emergency contraceptions

A

high doses of oral progestins

high doses of COCs(combined

oral contraception) or estrogen
insertion of copper IUD

172
Q

example of oral progestins

A

plan b one step

plan b two step

173
Q

over the counter for ages 15 and older

A

plan b one step

174
Q

over the counter for 17 & older

need prescription for younger than 17

A

plan b two step

175
Q

when to insert the copper IUD

A

within 5 days after. 99% effective