Contraception, Abortion, Infertility

Question 1

contraception

Answer 1

intentional prevention of pregnancy during sexual intercourse

Question 2

birth control

Answer 2

the device or practice that decreases the risk of conceiving

Question 3

family planning

Answer 3

the conscious decision on when to conceive throughout the reproductive years

Question 4

natural family planning/fertility awareness-based methods

Answer 4

abstinence
coitus interruptus
calendar rhythm
standard days method
basal body temperature
2-day method
Billings method/cervical

Question 5

abstinence

Answer 5

refraining from sexual intercourse
most effective method of BC
can eliminate risk of STD spread
requires self control
high failure rate

Question 6

coitus interruptus

Answer 6

“withdrawal”, pull out method
one of the least effective forms of BC
pre-ejaculatory fluid can contain sperm
no protection against STDs

Question 7

calendar rhythm method

Answer 7

tracking menstrual cycle to determine time of ovulation
must count at least six cycles
most useful in combo w BBT or cervical mucus

start of fertile period: # of days in shortest cycle - 18
end of fertile period: # of days in longest cycle - 11
fertile period is between these days ^, so abstain from intercourse

Question 8

standard days method/cycle beads

Answer 8

unreliable for cycles longer than 32 days of shorter than 26 days
red bead- first, marks first day of menstrual cycle
brown beads- nonfertile days
white beads- fertile days

Question 9

basal body temperature BBT

Answer 9

temp rises during ovulation, dropping right before
most effective in use with calendar method
take temp immediately upon waking
the first day the temp drops or elevates is the first fertile day
fertility extends through 3 consecutive days of temp elevations

Question 10

2 day method

Answer 10

check for PRESENCE of vaginal secretions daily
after 2 days without the presence of vaginal secretions, the fertile period has passed
avoid sex when vaginal secretions are present for 2 days in a row

Question 11

billings method/cervical mucus ovulation detection

Answer 11

analyze cervical mucus to determine ovulation
good hygiene
begin from last day of menstrual cycle
spinnbarkeit sign- stretchy ovulatory discharge during ovulation (like egg whites)
fertile period: when the mucus is thin and slipper until four days after it last appears this way

Question 12

barrier methods

Answer 12

male condom
female condom
spermicide
diaphragm
cervical cap
contraceptive sponge

Question 13

male condom

Answer 13

protects against UTIs
made of latex, polyurethane, or natural membrane
only use water soluble lube

Question 14

female condoms

Answer 14

protect against STIs
made of nitrile, a ring that is pre-lubricated with spermicide
do not use w male condoms

Question 15

spermicide

Answer 15

decreases sperm mobility
available OTC
insert at least 15 min (but no longer than 1 hr) before sex
do not remove until 6 hrs after sex
must reapply with each act
nonoxynol-9 increases risk of HIV if used more than twice daily

Question 16

diaphragm

Answer 16

cup with rim made of silicone covering the cervix
spermicide must be reapplied with each act
must stay in place for at least 6 hours after sex
can be reused but replace after 2 years
wash with warm water and mild soap
requires prescription
risk for toxic shock syndrome (signs: high fever, faint feeling, macular rash, hypotension, diarrhea, HA, muscle aches)
not for pts who have frequent UTIs, history of TSS, cystocele, or uterine prolapse

Question 17

cervical cap

Answer 17

silicone rubber cap that fits tightly around the base of the cervix
replace every 2 years
no additional application of spermicide needed
not for pts who have abnormal pap results or history of TSS

Question 18

contraceptive sponge

Answer 18

concave polyurethane sponge containing spermicide, fits over cervix
one size fits all
provides protection for up to 24 hrs

Question 19

hormonal methods

Answer 19

combined oral contraceptives (COCs)
progestin-only pill (minipill)
emergency oral contraceptive
transdermal contraceptive patch
injectable progestins
contraceptive vaginal ring
implantable progestin
intrauterine device (IUD)

Question 20

combined oral contraceptives (COCs)

Answer 20

estrogen and progestin thins uterine lining and thickens cervical mucus to block and prevent semen implantation
if one pill is missed, take two the next day
increases risk for thromboembolism, stroke, HTN
estrogen cannot be given to pts within 6wks postpartum

Question 21

warning signs for pts taking COCs

Answer 21

Abdominal pain
Chest pain /sob
Headaches
Eye problems
Severe leg pain

Question 22

progestin-only pills (minipills)

Answer 22

cannot miss a pill
given to pts postpartum

Question 23

estrogen causes…

Answer 23

nausea
breast tenderness
fluid retention

Question 24

progestin causes…

Answer 24

increased hunger
fatigue
depression
oily skin and scalp

Question 25

emergency oral contraceptive

Answer 25

morning-after pill that inhibits the transport of sperm
taken within 72hrs after unprotected coitus
take pregnancy test if menstruation does not begin with 21 days
SE: nausea, heavy bleeding, lower abd pain, fatigue, HA

Question 26

transdermal contraceptive patch

Answer 26

can be combined or just progestin
apply patch to subcutaneous buttock, abdomen, upper arm, or torso
replace patch each week for three weeks
thickens cervical mucus
less effective in pts over 198lbs

Question 27

injectable progestins

Answer 27

IM or SQ (depo is IM)
given during first 5 days of menstrual cycle
given every 3 months
SE: irregular bleeding before amenorrhea, reversable bone loss, weight gain
do not massage injection site

Question 28

contraceptive vaginal ring

Answer 28

silicone ring that contains etonogestrel and ethinyl estadiol (nuvaring)
replace ring after 3 weeks
if removed for more than 4hrs, replace and use a barrier method for 7 days
can be removed for up to 3hrs without changes to effectiveness

Question 29

implantable progestin

Answer 29

small thin rod under the skin of the inner upper aspect of the arm (nexplanon)
suppress the ovulatory cycle by releasing progestin
lasts 3 years

Question 30

intrauterine device (IUD)

Answer 30

T-shaped device inserted through the cervix and placed in the uterus
kyleena= 5yrs
mirena and liletta=8 yrs
copper=10 years
increases risk for PID
copper IUD SE: increased menstrual pain and bleeding
check for strings after each menstruation
CI in pts w known STDs

Question 31

transcervical sterilization

Answer 31

a nonhormonal mean of BC that results in scar tissue in fallopian tubes
requires no GA
very effective
not reversable
delay in effectiveness for 3 months

Question 32

bilateral tube ligation

Answer 32

female sterilization
surgical procedure severance/burning/blocking of the fallopian tubes to prevent fertilization
permanent
decreases ovarian cancer incidence

Question 33

vasectomy

Answer 33

male sterilization
surgical procedure ligation and severance of vas deferens
requires local anesthetic
takes 20 ejaculations to clear vas deferens of sperm
sperm count must be 0 on 2 consecutive occasions to confirm sterility

Question 34

signs of endometritis

Answer 34

chills and fever 101+
abd tenderness when palpated
foul smelling discharge

Question 35

infertility

Answer 35

inability to conceive despite engaging in unprotected sexual intercourse for at least 12 mo

Question 36

sterility

Answer 36

inability to conceive

Question 37

subfertility

Answer 37

prolonged time to conceive

Question 38

female inferility causes

Answer 38

anovulation and irregular cycles
tubular occlusions
uterine structure anomolies

Question 39

anovulation and irregular cycles

Answer 39

r/t thyroid issues, PCOS, prolactinomas (nipple drainage)
treat: induce period or ovulation induction (letrozole and clomiphene)

Question 40

clomiphene risk

Answer 40

twins

Question 41

tubular occlusions

Answer 41

can be r/t history of STD
assess tubal patency by hysterosalpingogram

Question 42

uterine structure anomolies

Answer 42

vaginal septum, uterus didelphis (2 cervixes), uterine fibroids (can be removed via myomectomy but causes scar tissue)

Question 43

ways to diagnose infertility

Answer 43

transvaginal ultrasound
laparoscopy (under GA)
hysteroscopy
hysterosalpingography (assesses fallopian tube patency)
day 21 progesterone lab test

Question 44

assisted reproductive techniques (ART)

Answer 44

intrauterine insemination
IVF-ET
gamete intrafallopian transfer
donor oocyte
donor embryo
gestational carrier
surrogate mother
therapeutic donor insemination

Question 45

intrauterine insemination (IUI)

Answer 45

place sperm in uterus at time of ovulation

Question 46

in vitro fertilization-embryo transfer (IVF-ET)

Answer 46

collect eggs from ovaries, fertilize eggs in lab with sperm, transfer embryo to the uterus

Question 47

gamete intrafallopian transfer

Answer 47

oocytes are retrieved and place with prepared motile sperm, both placed in catheter to form gametes. then inject gametes into fallopian tubes via laparaacopsy

Question 48

donor oocyte

Answer 48

donor eggs are collected from donor by IVF procedure
eggs become inseminated and embryos get placed in the recipient’s uterus

Question 49

donor embryo (embryo adoption)

Answer 49

donated embryo is placed in the recipient’s uterus

Question 50

gestational carrier (embryo host)

Answer 50

a couple completes the IVF process with the embryo placed in another person who will complete the pregnancy

Question 51

surrogate mother

Answer 51

a person is inseminated with semen and carries the fetus until birth

Question 52

therapeutic donor insemination

Answer 52

donor sperm is used to inseminate a person

Question 53

induced abortion

Answer 53

either elective or therapeutic
purposeful interruption of pregnancy before 20 weeks gestation

Question 54

earliest a baby can survive is…

Answer 54

22-24 weeks

Question 55

medical abortion

Answer 55

give Cytotec
causes cervical ripening and contractions with bleeding

Question 56

surgical abortion

Answer 56

D&C
cervix dilated, suction out contents
used for 2nd trimester abortions and miscarriages

Question 57

medication used for ectopic pregnancies

Answer 57

methotrexate