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Nurp 501 > Week 2- Contraceptives > Flashcards

Week 2- Contraceptives Flashcards

1
Q

Women use contraceptives for how many years of their life?

A

30

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2
Q

Percent of pregnancies that are unplanned or unintended?

A

50

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3
Q

Percent of pregnancies that are unplanned and are voluntarily terminated?

A

40

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4
Q

Definition of family planning?

A

The number and timing of pregnancies

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5
Q

Birth control is:

A

To prevent pregnancy and limit the number of children

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6
Q

What is the IUD made just for adolescents?

A

Skyler

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7
Q

What is the least effective contraceptive method?

A

Fertility awareness method

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8
Q

What does the standard day method do?

A

Looks at the days of your cycle and tells you which days you are fertile

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9
Q

What is the basal body temperature method?

A

Looks for change in temperature of 0.4F which shows ovulation
Take same time every day

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10
Q

What is the hormone responsible for the rise in your body temperature with ovulation?

A

Progesterone released by the corpus luteum

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11
Q

What are the risk with the diaphragm and the cap?

A

If they leave in for longer than 24 hours can get TSS

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12
Q

If they have a history of TSS what contraception do we not recommend?

A

Diaphragm or the cap

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13
Q

If you leave in the diaphragm or cap in longer than 24 hours what are you at risk for?

A

Bladder infections
TSS
Infection

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14
Q

What is an advantage to women who use the diaphragm or cap?

A

Female regulated

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15
Q

Do you have to be fitted for the sponge?

A

No

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16
Q

What’s the main advantage of barrier methods like condoms?

A

Conception

Prevent some STDs

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17
Q

Can you use more than one barrier method at a time?

A

No- breakage

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18
Q

Which male Condom is more effective than the other? Why?

A

Latex

Non-latex is more brittle and doesn’t stretch like latex

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19
Q

18 year old is not sexually active and wants birth control. Is a pelvic exam necessary?

A

No

Just need BP- no COC for HTN

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20
Q

When prescribing birth control what is the main subjective family history you need to collect?

A

History of blood clots, cardiac history, coagulation disorders

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21
Q

What are contraindications to prescribing combined COC?

A 
History of migraine with auras
HTN
Risk of blood clot 
Cancers- breast, ovarian 
Active liver disease  
Active gallbladder disease 
Greater than 35 and smokes 
4 weeks postpartum
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22
Q

What medications make COCs less effective?

A

Anti-convulsants
Rifampin
HIV antivirals

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23
Q

If you do a quick start method of birth control what do you need to verify first? What teaching is needed?

A

Not pregnant and what other birth controls she is using, has she had sex since menses.

She will need to use back-up for first 7 days

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24
Q

If you are not within the first ___ days of your menstrual cycle you have to use backup for 7 days?

A

5

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25
Q

What is the number one chosen birth control method by women?

A

COCs

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26
Q

COCs are ___ % effective?

A

91

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27
Q

Are progesterone or estrogen methods safer?

A

Progesterone

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28
Q

Do progesterone or estrogen birth control methods cause side effects like HA and nausea?

A

Estrogen

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29
Q

What do you tell a woman that misses her Sunday pill and it is now Monday?

A

Take it right away and continue as normal

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30
Q

If a patient forgot to take Saturday and Sunday birth control pills, and it is Monday, so 48 hours without a pill, what do you tell her?

A

Start on the day you are on, use a back-up method for 7 days

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31
Q

What combines birth control method do we worry about a woman’s weight and it not being effective?

A

The patch

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32
Q

At what weight may the patch be ineffective?

A

196

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33
Q

How does the ring work?

A

Body temperature causes the hormones to release slowly everyday

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34
Q

How long can the ring be left out of the body before you need to use a back up method?

A

3 hours

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35
Q

What birth control method would you recommend for a woman who is 35 and smokes?

A

Depo or progestin only pill

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36
Q

What does depo do?

A

Suppresses ovulation and LH

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37
Q

How does the progesterone only pill work vs combined?

A

Combines prevents ovulation

Progesterone only creates a cervical mucous plug so spermatogenesis can’t get to the cervix.

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38
Q

Does the progesterone only pill prevent ovulation?

A

No

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39
Q

Does depo-provera suppress ovulation?

A

Yes- high does progesterone

40
Q

What are some non-contraceptive benefits you can get from birth control pills?

A

Prevent acne
Helps with heavy periods
Protects against anemia

41
Q

If you are prescribing birth control for dysmenorrhea, how long should you wait to see relief?

A

2-3 months

42
Q

What is first line therapy for dysmenorrhea?

A

NSAIDS

43
Q

What does LARC stand for?

A

Long acting reversible contraception

44
Q

Is LARC hormonal or nonhormonal?

A

Can be both

45
Q

What is a non-hormonal LARC?

A

Copper IUD - Paraguard

46
Q

Which LARC has progesterone?

A

Levo something

47
Q

Which LARC is for adolescents or nulluparous women?

A

Skylar, kylena

48
Q

What is the number one downfall of LARCs?

A

Can cause irregular bleeding

49
Q

Which LARC can you get pregnant within 6 weeks of removal?

A

Nextplanon

50
Q

How long after removal of depo can you get pregnant?

A

14-36 weeks

51
Q

What can you do if patient is on a LARC and is having heavy irregular bleeding?

A

COC if not contraindicated

High dose NSAIDs 800mg TID for 5 days

52
Q

How long can irregular bleeding last with the initial placement of a LARC?

A

Up to 12 months

53
Q

Do you need to test for STIs prior to IUD insertion?

A

No

54
Q

Before placing an IUD you need to do a pelvic exam, what are you looking for?

A

Enlarged uterus- pregnancy

Fibroid of the uterus

55
Q

IUDs and nexplanon are almost ___% effective?

A

100

56
Q

What effect does the copper IUD have on periods?

A

Can make them heavier

57
Q

Would you give a woman with dysmenorrhea a copper IUD?

A

No

58
Q

What are some non-contraceptive benefits of iuds?

A

Can prevent endometrial cancer or cervical cancer

Can cause amenorrhea

59
Q

What IUD can be used as an emergency contraceptive?

A

Copper iud

60
Q

How long after unprotected sex can you insert a copper iud?

A

Up to 5 days

61
Q

What are the other options for emergency contraception besides a copper iud?

A

Morning after pill-plan b- 17 or older OTC

Prescription plan B- Ella

62
Q

How does Ella, the prescription plan B work?

A

Progesterone antagonist

63
Q

What is the advantage to Ella?

A

It’s more effective

Don’t have to worry about weight making ineffective

64
Q

Plan b is only indicated for up to ___ days after unprotected sex but can be used up to ___ days but will be less effective.

A

3

5

65
Q

Ella is effective up to ___ days?

A

5

66
Q

A postpartum woman should avoid estrogen containing birth control for at least ____ due to what risk? What

A

4 weeks

DVT

67
Q

What risks are associated with placement of IUD directly following birth?

A

Perforation of the uterus

Expulsion of the IUD

68
Q

What birth control can women start immediately postpartum?

A

Progesterone only

69
Q

What is the lactation amenorrhea method of birth control?

A

Must be exclusively breastfeeding

Effective up to 6 months

70
Q

At what week gestation are you unable to have a medical abortion and must do a surgical abortion?

A

After 9 weeks

71
Q

Methotrexate may be used up to what week gestation?

A

7

72
Q

Mifepristone may be used up to what week gestation?

A

9

73
Q

After 9 weeks gestation, what is the most common form of abortion and up to what week can this be done?

A

Aspiration

12 weeks

74
Q

What form of abortion can be done up to 13 weeks?

A

DNC

75
Q

What form of abortion must be done after 13 weeks?

A

Dilation and evacuation

76
Q

With typical use what is the noneffective rate of coitus interruptus?

A

12%

77
Q

Due to high levels of prolactin this method inhibits secretion of GnRH that sets off the HPO axis and prevents ovulation.

A

Lactational amenorrhea method

78
Q

What conditions must be met for LAM?

A

Infant must be exclusively breastfed. (No longer then 4 hours between feeds in the day and 6 hours at night)
Infant younger than 6 months.
No return of maternal menses.

79
Q

What is the lifespan of the ovum?

A

12-24 hours

80
Q

How long is sperm viable?

A

3-5 days

81
Q

What is the rhythm method?

A

1st fertile day is shortest cycle - 18

End of fertile days is longest cycle - 11

82
Q

For standard days method how long does your cycle need to be and what days do you abstain from sex?

A

26-32 days

Abstain days 8-19

83
Q

What is the Billings ovulation method?

A

Uses change in cervical mucous to determine fertile window. Abstain from sex from day 1 of elastic like cervical mucus until 4 hours after gone.

84
Q

What method do you abstain from sex on days 10-14 of cycle or when you answer yes to:
Did I notice any secretions today?
Did I note any secretions yesterday?

A

The two day method

85
Q

With the basal body temperature what rise in temperature indicates ovulation?

A

At least 0.4 degrees F

86
Q

What causes the rise in temperature with ovulation?

A

Occurs as more progesterone is released by the corpus luteum, signaling ovulation has occurred.

87
Q

This method uses BBT, cervical mucus plug, and cervical observations.

A

The symptothermal method

88
Q

Following ovulation, what does the cervix do?

A

It becomes more firm and lower in the vaginal canal and closed.

89
Q

Subdermal implants like nexplanon are inserted under the skin and continuously release what which does what?

A

Progestin (progestin only devices)

Suppresses ovulation

90
Q

Side effects of nexplanon:

A

Irregular bleeding, blood pressure (monitor twice a year), acne, increase in weight, nausea, headache.

91
Q

How long after nexplanon insertion may the patient have irregular bleeding?

A

Up to 3 months (spotting)

92
Q

This device the primary contraceptive effect is provided by the reaction of having a foreign body in the reproductive tract- specifically- a sterile inflammatory response that has spermicidal effects.

A

Copper IUD

93
Q

What is the PAINS mnemonic for IUD?

A

Watch for period, abdominal pain, infection, not feeling well, strong missing

94
Q

These are least effective protection, are meant to be used with a barrier method, and increase risk of STIs due to micro-abrasions in vaginal mucosa.

A

Spermicidal agents

95
Q

Estrogen in birth control suppresses the production of what, thereby preventing selection and emergence of a dominant follicle.

A

FSH

96
Q

What is the ACHES mnemonic for birth control?

A 
Use to remember adverse events and when patient needs to be see :
Abdominal pain 
Chest pain 
Headache 
Eyes/vision 
Severe leg pain
97
Q

A medical abortion can not be given to women with:

A

Coagulopathy
Seizure disorder
Liver/renal disorders

Nurp 501 (8 decks)

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