family planning and contraception

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Author:
Prittyrick
ID:
300026
Filename:
family planning and contraception
Updated:
2015-04-05 10:28:24
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contraception
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  1. methods
    • natural family planning also known as reversible methods
    • barrier method
    • hormonal method
    • surgical method
  2. Natural family planning reversible method
    • abstinence
    • calendar method- 2 day method- risk for sti
    • withdrawl/coitus interrupts
    • fertility awareness based method:
    • - symptom method: cervical mucous
    • - basal body temp- decre
    • - symtothermal method
    • - home predictor kits
    • lactational amennorrhea method- breast feeding (LAM)
  3. PP: LAM
    • effective for 6 m only if:
    • has not had period since she gave birth
    • breast feeds daily on both breast 6 time/day
    • breast feeds baby on demand q 4 hours at least
    • does not substitute other food
    • provide night time feeding every 6 hours
    • do not rely on this method after 6 m
  4. barrier method
    • condoms: males/femals
    • - only method besides abstinence that will protect from sti
    • the other will not protect
    • - diaphram spermicides
    • - cervical cap
    • - contraceptive sponge
  5. education condoms males and females
    • only one time use
    • observe for expiration, tear prior to use
    • keep cool
    • males:
    • - must leave an empty sac at tip for sperm
    • - withdraw while penis is erect and hold rim of condom so u dont have spillage
    • - only water soluble lubricate should be used with latex to prevent breakage
    • - caution with latex condoms
    • females
    • - can be worn up to 8 hours after intercourse
  6. barrier method caution
    • incr risk for toxic shock syndrome (TSS)contraindicated: women with hx of TSS
    • TSS caused by a bacteria infection s/s
    • - high fever, faint feeling, hypotension, watery diarrhea, headache, and muscle aches
    • - may result in multi system failure and death
  7. Hormonal method
    • rely on estrogen and progestin or progestin (only) to prevent ovulation
    • ┬ámethods:
    • - oral contaceptives
    • - injectable
    • - implants
    • - vaginal rings
    • - transdermal patches
  8. Hormonal method oral
    • Combined
    • - estrogen and progesterone
    • - suppressive ovulation, thicken cervical mucous, alter uterine endometrium
    • - disad- breast tender, DVT, stoke
    • Minipill
    • - progesterone only
    • - thickens cervical mucous- makes hostile environment
    • used for women who can not take estrogen (hx of dvt, cancer,)
    • - safe for breast feeding women
  9. hormonal method (emergency, injection
    • emergency contraception
    • oral: dosage with 72 hour of intercourse
    • makes uterus not plantable
    • dont make this the permanant method
    • combined estrogen and progesterone (yuzpe regimen, planned b one step (levonorgesterol)
    • cooper bearing IUS within 5 days of intercourse
    • Injectable - dep provera (progesterone only)
    • administer IM q 11-13 weeks
    • first day of menstrual cycle
    • postpartum: non breast feeding- within 5 days, breast feeding in the 6th week
  10. hormonal method (transdermal, rings, implanted deviced)
    • Transdermal:
    • patch with hormones placed on the skin
    • - 3 weeks on 1 week off
    • - estrogen and progesterone
    • Vaginal rings:
    • - hormones absorbed thru vagina epithelium
    • - 3 weeks in 1 week out
    • implanted devices
    • - intrauterine device (IUD)
    • - transcerical sterilization- put in tubes
  11. signs of complication hormone users ACHES
    • A- abd pain may indicate gallbladder and liver problems
    • C- chest pain SOB may indicate pulomonary embolism
    • H- headaches, may indicate HTN or impeding stroke
    • E- eye problem may indicate HTN or impeding stroke
    • S- severe leg pain may indicate DVT
    • mimic pregnancy
  12. Patient education: hormonal therapy
    • do not skip dose
    • meds that interfer with effectiveness:
    • - antibiotics, anticonvulsants,
    • combined oral contraceptives
    • - contraindicated for women with hx of clots, stroke, cardiac problem, breast or estrogen related cancers, pregnancy, smoking (over 35 yrs of age)
    • do not protect against STI
    • adolescents the most difficult to education
  13. other uses for hormonal therapy
    • treatment for endometriosis
    • treatment for acne or hirsutism (excessive hair)
    • decre incidence of eptopic pregnancy, acute PID
    • decre perimenopausal symptoms, maintaining bone density
    • incre menstrual cycle regularity
    • reduces pregnancy related death
    • treatment of dysfunction uterine bleeding and dysmenorrhea
  14. Surgical method
    • consider sterilzation
    • female: tubal ligation: (bilateral tubal ligation salpingectomy)
    • - done in the operating room
    • - done laparoscopic techique
    • - often requires general anesthesia
    • Male: vasectomy
    • - done in the md's office with local anesthesia
  15. birth control for breast feeding mom
    • natural family planning methods
    • - do not rely on ovulation
    • barrier method such as condoms and spermicide
    • - diaphram and cervical cap will need sizing after 6 weeks
    • oral contraceptive
    • - mini pill- progestin
    • Injectable
    • - depo provera- injectable progestin
    • implantable IUD
  16. Caution of all PP women
    • combined hormonal therapy should not be prescribed
    • - 21 days PP without hx of DVT
    • - 42 days PP with Hx of DVT, c-section
    • - related to hypercoagulation stage of pregnancy
    • - not prescribe breast feeding women due to potential interfering with lacation
    • use barrier method, spermicide until you know which method u want to use

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