Chapter 1 Contraceptives

Question 1

Abstinence

Answer 1

Eliminates the possibility of sperm entering the vagina

100% effective

Question 2

Coitus interruptus withdrawal

Answer 2

Withdrawal of penis from vagina prior to ejaculation

78% effective

Least effective method
NO STD PROTECTION

Question 3

Calendar rhythm method

Answer 3

Tracking the menstrual cycle to estimate the time of ovulation (14 days after onset of period)

76% effective

Question 4

Basal Body temperature

Answer 4

Prior to ovulation, the temperature drops slightly and rises during ovulation

76% effective

Take temperature immediately after waking up and before getting out of bed

*the first day the temperature drops or elevated is considered first fertile day

Question 5

Cervical mucus ovulation detection method

Answer 5

Following ovulation the cervical mucus becomes thin and flexible under the influence of estrogen and progesterone to allow for sperm viability and motility

76% effective

Examine mucus the last day of cycle. Fertile period begins when the cervical mucus is thin, slippery and last until 4 days after the last day of cervical mucus having this appearance

Good hand hygiene

Cervical mucus that looks like egg whites indicates ovulation and SPINNBARKEIT SIGN (clear stretchy)

Question 6

Male condom

Answer 6

Latex rubber, polyurethane, or natural membrane covering penis during intercourse

84% effective

Protects against most STD’s
NO ADVERSE EFFECTS

CHECK EXPIRATION DATE
NATURAL SKIN CONDOMS DO NOT PROTECT AGAINST STD

ONLY WATER SOLUBLE LUBRICANTS SHOULD BE USED WITH LATEX CONDOMS

Question 7

Female condom

Answer 7

Vagina sheath made of nitrile; a non latex synthetic rubber with flexible rings on both ends that is pre-lubricated with a spermicide

Question 8

Spermicide

Answer 8

Chemical barrier that is available in a variety of forms, and destroys sperm before they can enter the cervix.

•15 mins before intercourse
• effective for 1 hr after insertion
• DO NOT REMOVE until 6 hrs After intercourse

Question 9

Diaphragm

Answer 9

A dome shaped cup with a flexible rim made of silicone that fits snuggly over the cervix
(Mode effective with the use of spermicidal cream or gel)
•replace every 2 years and refit for a 20% weight fluctuation
•can be inserted up to 6hr before and must stay in place 6hr after but no more than 24 hrs
•Wash with mild soap and warm water after each use

Question 10

Cervical cap

Answer 10

Silicone rubber cap that fits tightly around the base of the cervix

•use with a spermicide increases it’s effectiveness
• insert up to 6 hrs before and leave in at least 6 hrs after but no more then 48 hrs
•replace every 2 years and refit after gyn surgery, birth or weight fluctuation

Question 11

Contraceptive sponge

Answer 11

Small, round, concave-shaped, polyurethane sponge containing spermicide (fits over the cervix)

•one size fits all
•moisten with warm water prior to insertion
• leave in for 6 hrs after and protects for up to 24 hrs

Question 12

Combined oral contraceptives

Answer 12

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

Question 13

Progestin only pills (minipill)

Answer 13

Oral progestins that provide the same action as combined oral contraceptives, which decreases the chance of fertilization and implantation

•TAKE AT THE SAME TIME DAILY
• DO NOT MISS A PILL

Question 14

Emergency oral contraceptive

Answer 14

Morning after pill that prevents fertilization from taking place by inhibiting ovulation and the transport of sperm

• take within 72 hrs after unprotected coitus
• take a OTC antiemetic 1 hr before to prevent nausea

Question 15

Injectable progestins
Medroxyprogesterone (DEPO SHOT)

Answer 15

An intramuscular or subcutaneous injection given to a female client every 11 to 13 weeks

• start the first 5 days of the menstrual cycle and every 11 to 13 weeks thereafter
• maintain calcium intake and engage in weight bearing activities to decrease the risk of osteoporosis
DO NOT MASSAGE IM INJECTIONS
CONTRAINDICATIONS: CARDIAC, CANCER, LIVER
CAN IMPAIR GLUCOSE TOLERANCE FOR CLIENTS THAT HAVE DIABETES MELLITUS

Question 16

Contraceptive Vaginal Ring

Answer 16

A flexible silicone ring that contains etonogestrel and estradiol, which are delivered at continuous levels vaginally

•replace after 3 weeks and placement of new ring within 7 days
•insert same day of the week monthly

Contraindications
BLOOD CLOTS, HTN, stroke, heart attack

Question 17

Implantable progestin

Answer 17

Small, thin rods consisting of progestin that are implanted by the provider under the skin of the inner upper aspect of the arm. Prevents pregnancy by suppressing the ovulatory cycle and thickening cervical mucus.

•report late or abnormal spotting or
bleeding, abnormal pain during intercourse, foul smelling discharge, fever, chills, change in string length, or if IUD cannot be located.

EFFECTIVE FOR 3 YEARS
can get immediately after abortion, childbirth and e-bike breastfeeding

REVERSIBLE

Question 18

IUD (Intrauterine device)

Answer 18

A chemically active T shaped device that is inserted through the cervix and placed in the uterus by the provider.
Released a chemical substance that damaged sperm in transit to the uterine tubes and prevents fertilization.

MOST EFFECTIVE AT PREVENTING PREGNANCY ARE LARC

can be used by nulliparous and multiparous female clients

Monitor monthly

Effective for 3-10 years (hormonal 3-5 and cooper 10 years)

Risk: BV, PID, uterine Perforation or uterine expulsion

Contraindications: active pelvic infection, abnormal uterine bleeding, severe uterine distortion

Question 19

Transcervical sterilization

Answer 19

Insertion of small flexible agents through the vagina and cervix into fallopian tubes. This results in the development of scar tissue in the tubes, preventing conception.

•Examination must be done after 3 months to ensure fallopian tubes are blocked.
•99.8 % effective in preventing pregnancy
•Nonhormonal
•use an alternative means of birth control until confirming the fallopian tubes are blocked

Pregnancy can occur if unprotected sex occurs during the first 3 months

Question 20

Female sterilization
(bilateral tubal ligation)

Answer 20

A surgical procedure consisting of severance and/or burning or blocking the fallopian tubes to prevent fertilization

•permanent and can be done 24 to 48 hours after childbirth
•decreases the incidence of ovarian cancer

Risk: erotic pregnancy

Question 21

Male sterilization
(Vasectomy)

Answer 21

A surgical procedure consisting of ligation and severance of the vas deferens, which prevents sperm from traveling

•Sterility is delayed until the proximal portion of the vas deferens are cleared of all remaining sperm (20 ejaculations)

•PERMANENT
Accumulation of sperm can cause granulomas