CNM Varney's Review Book Part A Flashcards Preview

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Flashcards in CNM Varney's Review Book Part A Deck (117)
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Cycle history last 12 months: shortest 26 days, longest 30 days. According to calendar method, what is the fertile period for this person?

Days 6-20 of her cycle.
Subtract 20 days from the shortest cycle,
subtract 10 days from longest cycle.


Who CANNOT use rhythm/calendar method?

menstrual cycle <25 days
irregular cycles
cycles that vary in length by 8 days or more
postpartum women
lactating women
perimenopausal women


In order to avoid pregnancy, the woman using the cervical mucus method of family planning should avoid intercourse for a minimum of how many days following the peak day of her cyce?

3 days


What is nonoxynol-9 and how is it beneficial?

Is the active ingredient in most spermicidal preparations and is available without rx.
In the laboratory, is lethal to agents that cause GC, CT. trich, syphilis, and AIDS
Lowers the chance of becoming infected with a bacterial STI/STD


Timing of spermicide use

If you do not have sex within 1 hour of inserting the spermicide, need to reapply it


What lubricants are safe to use with polyurethane condoms?

Safe to use with any lubricant, including oil-based


What is the minimum amount of time after the last act of intercourse that a woman must leave a diaphragm in position in order to maximize contraceptive effectiveness?

6 hours


If a diaphragm is properly fit and cared for, how long is it good for?

2 years


Diaphragm facts

With typical use, failure rate ~18%
Frequency of intercourse significantly affects effectiveness among women who are consistent diaphragm users.
Use of spermicide significantly increases effectiveness of diaphragm.


32 yr old G2P1 successfully used a coil-spring diaphragm prior to birth of her child. Wishes to resume use. PE: uterus retroverted, arch behind symphysis pubis average, first-degree cystocele. Which method birth control to use?

A method other than a diaphragm
C/I in severe cystocele
severe uterine prolapse
severe anteversion or retroversion of uters
known allergy to the rubber of the diaphragm or to the accompanying spermicidal preparation


Cervical cap/spermicide in relation to inertcourse

with the cervical cap, additional spermicide is not needed for repeated acts of intercourse


Absolute contraindications for insertion of IUD

recurrent PID
cervical or uterine carcinoma
unexplained or abnormal uterine bleeding
hx or presence of valvular heart disease
Wilson's dz or allergy to copper
uterine sound measurement outside 6-9 cm
genital actinomycosis
cervical mycosis


prerequisites to insertion of IUD

informed consent form
pregnancy test
GC/CT cultures


woman with IUD and +Uhcg is at increased risk for

placenta previa
ectopic pregnancy


Which progestin is used as the index progestin in order to compare the biological potency of the various progestins used in oral conntraceptives?



Why should you delay the initiation of COCP in pp woman who is not breastfeeding?

because earlier initiation of COCP can increase risk of thromboembolism


How soon after a first-term abortion can a woman safely start taking COCP?



what is the main mechanism of action of COCP to prevent pregnancy?

suppression of ovulation by suppression of FSH and LH


which sx should be reported immediately by a woman who is taking OCP?

hemoptysis (expectoration of blood-tinged mucous)


To ensure maximal contraceptive effectiveness and minimize chances of breakthrough bleeding, when in cycle should OCP be started?

within the first five days of the cycle


for at least how long shoudl a woman use back-up contraception if she has issed two of her COCPs?

7 days


Woman started COCP 2 months ago, is having breakthrough bleeding with each cycle. What do you do?

recommend that she use a back-up method until the bleeding has stopped, and reassure her that in most cases btb will remit by her fourth pill cycle


spotting and btb in early half of cycle (days 1-9), it is most likely due to ...

estrogen deficiency


what contraceptives can be used as emergency contraception?

COCP, progestin-only pills, IUDs


what is the maximum amount of time after an unprotected act of intercourse that the Yupze regimen of oral contraceptive pills is considred to be effecdtive as a method of EC?

72 hours


maximum amount of time after unprotected intercourse that a copper IUD is considreed to be effective as method of EC?

5-7 days


What is Depo-Provera's main mechanism of action?

suppression of ovulation by suppression of FSH and LH


most common side effect of Depo-Provera

menstrual changes


is depo protective against PID?



how soon after birth can a woman who is breastfeeding initiate Depo?

6 weeks pp