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OB ch 1
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1
Question
advantages of abstinence?
Answer
* MOST effective method of birth control no chemical or objects in the body, eliminates the risk of STI/STD, Assistance during fertile periods = can be used but REQUIRES an understanding of the menstrual cycle and fertility awareness
2
Question
disadvantages of abstinence?
Answer
self-control, high failure rate bc lack of adherence
3
Question
pt education on abstinence?
Answer
refrain from sex, if complete abstinence is done NO RISK
4
Question
penile condoms pt education
Answer
put a condom on the erect penis and leave space at the tip for sperm reservoir, after sex take off while holding the rim, you can use spermicidal gel, check the expiration date, latex, and polyurethane condoms protect against STIs but natural skin NO!! polyurethane is not as effective compared to latex (OVERALL NOT 100% EFFECTIVE AGAINST STIS OR STDs
5
Question
advantages of penile condoms?
Answer
protects against most STIs!! no adverse effects and easily accessible
6
Question
disadvantages of penile condoms?
Answer
high rate of nonadherence, reduced spontaneity of sex, decreased sensation, the penis has to be hard before applying, DOES NOT PROTECT AGAINST STIs that are transmitted from lesions on skin !!!!!
7
Question
what is a diaphragm ?
Answer
dome coned-shaped cup that is silicone and fits snugly over the cervix. works even better with spermicide. COMES IN DIFFERENT SIZES
8
Question
pt education on diaphragm
Answer
need to be properly fitted by the provider, replaced q 2 yrs and refit 20% weight fluctuations and after abdominal or pelvic surgery and after pregnancy, inserted 6 hrs before sex and MUST STAY 6 hrs after 6 BUT NO LONGER THAN 24HRS, spermicide reapplied w each sex act, empty bladder before putting it on, washed with mild soap and warm water with each use
9
Question
advantages of the diaphragm?
Answer
Pt have more control over contraception, easy to use
10
Question
the disadvantages of the diaphragm?
Answer
No spontaneous sex requires re-application of spermicidal gel, requires a prescription, NO PROTECTION AGAINST STIS
11
Question
Risk/complications/ contraindications of a diaphragm?
Answer
NO PTS WITH HX OF TOXIC SHOCK SYNDROME (TSS), cystocele, uterine prolapse, or freq UTIS, increased risk of getting TSS, proper hand hygiene prevents TSS and removing 6-8 hrs after sex
12
Question
combined oral contraceptives (COCs) what does it contain and action?
Answer
has estrogen and progestin, acts by suppressing ovulation and thickening the cervical mucus to block sperm
13
Question
pt education of COCs?
Answer
requires a prescription and follow-ups, routine paps and breast exams may be needed, REQUIRES consistent and proper use to be effective, a period should come during last 7 days, REPORT manifestations of: CHEST PAIN, SOB, leg pain, HA, vision changes, IF missing a dose TAKE IT ASAP if 2-3 pills missed following manufactures rules (tell pt to use other methods until getting back on track), nausea = HS
14
Question
advantages of COCs?
Answer
Highly effective if taken correctly !! (@same time each day), estrogen also helps decrease menstrual blood, iron deficiency, regulation of irregular periods, offers protection against endometrial, ovarian/ colon cancer reduces the incidence of breast cancer (begin), and improves acne
15
Question
Disadvantages of COCs and adverse effects?
Answer
No protection against STIs, increased risk of thromboembolism, stroke, MI, HTN, liver tumor, exacerbate fluid retention (migraines, epilepsy, asthma, heart disease, and kidney ), adverse effects HA, nausea, breast tenderness, breakthrough bleeding
16
Question
Risk/complications/contraindications of COCs?
Answer
HX of thrombotic disorders, stroke, MI, CAD, gallbladder disease, liver tumor or cirrhosis, HA with aura, uncontrolled HTN, DM, breast or estrogen-related cancer, pregnancy, lactating, less than 6 weeks pp, smoking (over 35) NO COCs, DECREASE IN EFFECTIVENESS WHEN TAKING THESE MEDS(bc liver enzymes) - anticonvulsants, antifungals, some antibiotics
17
Question
what is emergency oral contraceptive and action?
Answer
aka morning-after pills, prevents fertilization from taking place by inhibiting ovulation
18
Question
pt education of Emergency oral contraceptives AND COPPER IUD
Answer
Taken within 72 hrs after unprotected sex, the provider will recommend an antiemetic 1 hr before, be evaluated for pregnancy if the period doesn't come for 21 days, Copper IUD can be used up to 5 days following unprotected sex BUT PRESCRIPTION IS NEEDED
19
Question
advantages of emergency contraceptives?
Answer
anyone of age allowed to purchase
20
Question
Disadvantages of emergency contraceptives?
Answer
nausea, heavier menstrual bleeding, low abdominal pain, HA, NOT LONG TERM, DOESNT TERMINATE ONGOING PREGNANCY, NO PROTECTION AGAINST STIS
21
Question
contraindications of emergency contraceptives?
Answer
NO PREGNANT WOMEN OR WOMEN THAT HAVE UNDIAGNOSED ABNORMAL VAGINAL BLEEDING
22
Question
what is the minipill ?
Answer
progestin pill
23
Question
pt education on minipill?
Answer
Take the pill at the same time daily, DO NOT MISS A PILL, might need another form of birth control during the 1st month
24
Question
advantages of the minipill?
Answer
fewer adverse effects compared to COCs, SAFE DURING BREASTFEEDING
25
Question
What does advantages of the mini pill?
Answer
not as effective in suppressing ovulation, no sti protection, adverse effects: breakthrough bleeding, vaginal bleeding (most common), HA, nausea, breast tenderness
26
Question
contraindications of minipill?
Answer
no bariatric surgery, lupus, severe cirrhosis, liver tumors, current or past breast cancer