Flashcards in CNM Varney's Review Book Part A Deck (117)
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1
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.
2
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
3
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
4
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
5
Timing of spermicide use
If you do not have sex within 1 hour of inserting the spermicide, need to reapply it
6
What lubricants are safe to use with polyurethane condoms?
Safe to use with any lubricant, including oil-based
7
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
8
If a diaphragm is properly fit and cared for, how long is it good for?
2 years
9
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.
10
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
fistulas
known allergy to the rubber of the diaphragm or to the accompanying spermicidal preparation
11
Cervical cap/spermicide in relation to inertcourse
with the cervical cap, additional spermicide is not needed for repeated acts of intercourse
12
Absolute contraindications for insertion of IUD
recurrent PID
pregnancy
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
...
13
prerequisites to insertion of IUD
informed consent form
pregnancy test
GC/CT cultures
14
woman with IUD and +Uhcg is at increased risk for
sepsis
placenta previa
ectopic pregnancy
15
Which progestin is used as the index progestin in order to compare the biological potency of the various progestins used in oral conntraceptives?
Norethindrone
16
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
17
How soon after a first-term abortion can a woman safely start taking COCP?
immediately
18
what is the main mechanism of action of COCP to prevent pregnancy?
suppression of ovulation by suppression of FSH and LH
19
which sx should be reported immediately by a woman who is taking OCP?
hemoptysis (expectoration of blood-tinged mucous)
20
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
21
for at least how long shoudl a woman use back-up contraception if she has issed two of her COCPs?
7 days
22
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
23
spotting and btb in early half of cycle (days 1-9), it is most likely due to ...
estrogen deficiency
24
what contraceptives can be used as emergency contraception?
COCP, progestin-only pills, IUDs
25
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
26
maximum amount of time after unprotected intercourse that a copper IUD is considreed to be effective as method of EC?
5-7 days
27
What is Depo-Provera's main mechanism of action?
suppression of ovulation by suppression of FSH and LH
28
most common side effect of Depo-Provera
menstrual changes
29
is depo protective against PID?
yes
30
