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Female repro
2nd semester 2009 program
Question | Answer |
---|---|
What are the 2 assessments done for females | Breast & Genitalia. |
What do u assess in the breast exam | Nipples 4 drainage, cracking, edema, redness…Tissue do self exam, lungs. |
What do u assess in the genitalia | have 2 people room, assess pubic hair texture is it the same no bald spots & no lice, skin no lesions look 4 tears, external structures, speculum exam. |
Pelvic inflammatory disorders | inflammation from pathogens in the fallopian tubes or ovaries or both, may involve other structures except uterus spreads upward. |
What 3 things cause Pid | Streptococcus, staphylococcus, gonococcus. |
What PF contribute to Pid | Freq intercourse, multiple sex partners, Iud’s & child birth. |
Pid complications | Peritonitis, pelvis abcess, infertility, ectopic pregnancy. |
Peritonitis | Inflammation of peritoneum membrane covering the abd. |
S/S of Pid(faboslnd) | Low temp, pelvic abd pain, foul discharge, n/v, dysmenorrheal, dyspareunia, oophoritis, salpingitis. |
Salpingitis | inflammation of fallopian tubes. |
Oophoritis | inflammation of ovaries. |
Dyspareunia | painful intercourse. |
Dysmenorrhea | painful menstruation |
3 Dx test | Pelvic exam,vaginal & cervical c&s, ultrasound. |
Meds for Pid | D5LR or LR, antibiotics, vaginal suppositories. |
Surgery for Pid | Hysterectomy or removal of uterus. |
Things 2 assess 4 for Pid | Sex activity, # of partners, hx of contraception, prev vag infects, prev med tx, hygiene pract, increased temp, dry flushed skin, vag discharge, vag & cerv c&s. |
Endometriosis | growth of endometrial cells growing outside of the uterus in the pelvis. |
How many Rf does endometriosis have | 3, 30yrs or older, familial, Caucasian women |
S/S of Endometriosis | occur monthly not correlated w/ the severity of the disease: low backache, dyspareunia, heavy feeling in pelvis, spotting. |
Complications of Endo | Scar tissue, adhesions, infertility. |
Dx test for endo | Palpation pelvic exam & laparoscopy. |
Laparoscopy | Exam of internal pelvis structurs by direct visualization w/ laparoscope general anesthesia is used. |
Med tx for endo | based on age & desire for child bearing, pregnancy may help relieve symptoms. |
Surgical tx for endo | Hysterectomy, laparotomy(cauterization, lysis, laser vaporization) |
Rx goals for endo | Decrease s/s, reduce ovulation/menst., shrink implants |
Rx used for endo | oral contraceptives continuously, nafarelin acetate nasally inhibits cyclic hormone release, Danazol inhibits release of gonadotropian, results in amenorrhea supports growth of end tissue. |
Endo Rx se’s | oily skin, wt gain, fluid restricition, acne, hot flashes, metorrhagia, mastalgia, depression. |
Metorrhagia | breakthrough bleeding |
Mastalgia | Pain in breast. |
Things 2 look for in a pt wit endometriosis | pain, prolonged excessive menstruation, dyspareunia, pain with defecation. |
What is vaginitis | Inflammation of the vagina. |
What causes vaginitis | Bacteria, gardnerella, streptococcus, staphylococcus, herpes simplex 2, chlymadia trachomatis. |
What are the 5 common types of vaginitis | Candidiasis albicans(yeast), trichomonasis, gardnerella, chlymadia, post menopausal vaginitis. |
Pf’s of yeast | Obesity, pregnancy, douching, dm, abt’s, oral contraceptives. |
S/s of yeast | Irritation, burning, white patches in vagina, redness, edema, discharge, itching, thick white, cheesy curd like discharge w/musty odor. |
Med tx for yeast | Douche w/ white vinegar solution bid x 1 week, apply yogurt to labia (acidophilus), antifungal creams/suppositories for 7 days |
Antifungal creams for treating yeast | Miconazole, clotrimazole, nystatin. |
Cause of trichomonasis infection | Intercourse. |
S/s of trichomonasis | Itching, burning, green/yellow foul smelling frothy discharge. |
Med tx for Trichomonasis | Flagyl taken by mouth for both partners. |
S/S of Gardenerella infection | Asymptomatic, strong, fishy odor, itching & burning. |
Med tx for Gardenerella | Oral Abt: tetracycline hcl, ampicillin, flagyl, sulfa creams: sultrin, triple sulfa, antiviral creams qd or bid for 6-14 days. |
Chlymadia | s/s are asymptomatic. Complications are infertility. |
What dx test is done to diagnose chlymadia | Vaginal c & S. |
Med tx for chlymadia | Oral abt for 7 days & then repeat c & s. |
What causes postmenopausal vaginitis | Decreased estrogen levels. |
S/S of postmenopausal vaginitis | Dyspareunia, irritation, burning and itching. |
Med tx for postmenopausal vaginitis | Estrogen replacement: po, patch(transdermal), and vaginal. |
Teaching for postmenopausal vaginitis | Wear cotton panties, do not sit in wet bathing suit in warm weather, treat quickly, 8 oz of yogurt po qd w/ abt. |
Things 2 assess 4 in postmenopausal vaginitis1 | Bubble baths, panty hose, type of panties, hx of s/s, hx of menses, contraceptive methods, abt use |
Things 2 assess 4 in postmenopausal vaginitis2 | recent illness, sexual hx, Dm, usual hygiene, pregnancy hx, use of deodorant tampons or pads, c,c,a,o of discharge, scratches, irritation. |
What is toxic shock syndrome(tss) | A condition most associated w/ staph |
Cause of Tss | Staphylococcus aureus. |
Pf’s of tss | Tampon use, women under 30 yrs old. |
S/s of tss | Temp of 102 or greater, vomiting, diarrhea, flulike s/s malaise, muscle weakness, sore throat, and headache, macular erythematous rash (red, flat) followed in 1-2 wks by peeling of the palms & soles, dehydration, disorientation. |
Med tx of tss | Iv fluids, mechanical ventilation, Cpap used to force O2 in to the lungs. |
Dx test for tss | C & S for staph: in blood, urine, throat. |
Med tx for tss | Treat hypotension, stop infection, maintain ventilation, fluid volume replacement, encourage Iv fluids. |
Things 2 assess for w/ tss | Tampon use: freq of change duration of use, sore throat, ha, myalgia, fatigue, erythematous rash, edema, peeling of the palms & soles, hypotension Loc, nonpurulent conjunctivitis, hyperemia of the vagina and oropharynx. |
What are 2 types of benign neoplasms | Fibrocystic breast disease & fibroid tumors. |
What is fibrocystic breast disease | Hyperplasia of the epithelial cells leads to an icrease in fibrous tissue aka chronic cystic mastitis or lumpy breast syndrome. |
What are the causes and pf’s of fbd | Unknown, caffeine. |
S/s of fbd | Yellowish greenish sticky discharge from nipples. |
Hyperplasia | Over growth is the # of the cells. |
Hypertrophy | Over growth in the size of cells. |
Dx test used to diagnose fbd | Mammogram, bse pap smear on nipple discharge, biopsy (will tell if tumors are present either benign or malignant. |
Benign | not a threat to life or long-term health especially by being noncancerous. |
Malignant | Likely to cause harm or death cancerous. |
Surgery for fbd | Aspiration or incision to excise the tissue |
Rx used for fbd | Vit e qd |
Things to assess in fbd | Most recent mammogram, caffeine intake freq of bse, increased pain in lumps w/ menses, moveable lumps on breast exam. |
What is fibroid tumors leiomas | An overgrowth of cells in & around the uterus. |
What are the pf’s of fibroid tumors leiomas | Older than 30 yrs old & nulliparous. |
Nulliparous | Never having delivered infant after 24 wks gestation. |
S/s of fibroid tumors leiomas | Menorrhagia, increasing pelvic, pressure, dysmenorrheal, abdominal enlargement (b/c the fibroids are growing), constipation. |
Complications of fibroid tumors leiomas | Preterm delivery, fast growth (spreads & takes up a lot of space). |
Medical tx and surgery 4 fibroid tumors leiomas | Observe growth, myomectomy, d & c, & hysterectomy. |
Myomectomy | Surgical removal of uterine fibroids from the uterus. |
Diet for fibroid tumors leiomas | High in iron. |
Things 2 assess 4 in fibroid tumors leiomas | Ask about s/s, # of sanitary pads used in an hour, clots in menses, decreased hct, pale, hypotension, tachycardia. |
What is breast cancer | An overgrowth of mutated cells in the breast tissue. 2nd leading cause of death in women. |
Pf’s of breast cancer | Late menopause, onset of menses before 10y/o, high fat diet, moderate alcohol intake, smoking, over 65 y/o family hx, nulliparous, 1st pregnancy after 30y/o, hx fibrocystic breast disease obesity, never having breast fed, <1% of men. |
Dx test done to diagnose breast cancer | Pe, mammogram, bse. |
Stage 1 of breast cancer | Tumor smaller than 2cm, no lymph nodes test + for cancer cells, no evident metastases. |
Stage 2 of breast cancer | Tumor is between 2 & 5cm, 0-1 lymph nodes test + for cancer cells, no evident metastases. |
Stage 3 of breast cancer | Tumor is larger than 5 cm no lymph nodes test + for cancer cells/ no evident metastases or tumor is between 0 & 5 cm & lymph nodes test positive for cancer cells with no evident metastases. |
Stage 4 of breast cancer | Tumor is of any size, lymph nodes may/may no test + for cancer cells, evident metastases into other areas lungs, bone, brain, liver. |
s/s of breast cancer | Painless mass or thickening lump, pain or discharge from the nipple, unilateral change in breast size, dimpling or puckering orange peel appearance, microclusters tiny palpable clusters of calcium that feel like rocks |
Prevention of breast cancer1 | 20-40y/o-bse q mo, clinical bse q 3-4yrs |
Prevention of breast cancer2 | 41-49 y/o-bse q mo, clinical bse q 1-2 yrs, mammogram q 1-2 yrs |
Prevention of breast cancer3 | 50 yrs and up all above q 1yr |
Prevention of breast cancer4 | Tamoxifen helps prevent growth of tumors is given to high risk pts. |
Medication for breast cancer | Radiation & chemo |
Surgery for breast cancer | Lumpectomy, simple mastectomy, modified mastectomy, radical mastectomy. |
Lumpectomy | Surgical removal of tumor. |
Simple mastectomy | Removal of the tumor & a small portion of breast tissue. |
Modified mastectomy | Removal of the entire breast and nearby lymph nodes. |
Radical mastectomy | Removal of the entire breast, lymph nodes and underlying pecoralis muscle. |
Post op care for breast cancer surgery | Do not carry anything on affected side including a purse, do not draw blood, get shots or take bp on affected side, always wear med alert tag, may get prosthesis or reconstruction done. |
Rx for breast cancer pts | Antieoplastics: antiestrogens, androgens, alkalating agents, antitumor antibiotics, antimetabolites, steroids used in combo before or after or. |
Things 2 assess for in breast cancer | Lumps, discharge from nipples, unilateral changes, how longs, tender or non painful, less w/ menstrual cycle, last mammogram, v/s, wt, bse, last mammogram check, check s/s. |
Things 2 assess post op for breast cancer | v/s, incision, check emotional needs. |
What is cervical cancer | An overgrowth of mutated cells in the cervix of the uterus. |
Dysplasia | An early stage of the cancer a change in the size or shape of the cervical cells classified as mild, moderate or severe. |
Dx test for cervical cancer | Abnormal pap smear classified from 1 thru 5. 1 is considered normal 5 indicates a malignant condition. |
Pf’s of cervical cancer | Multiple sexual partners, hpv 35-55y/o, maternal use of dithylstibestrol during pregnancy. |
S/s of cervical cancer | Initially asymptomatic, abnormal bleeding, thin watery progressing to bright red, contact bleeding after intercourse, odor, pain in the lower back & groin, difficulty voiding, hematuria, rectal bleeding. |
Med tx of cervical cancer | Antibiotic cream or colposcopy followed by repeat pap depends on staging. |
Cervical stage 1 | No spread only on the cervix. |
Cervical stage 2-5 | Metastasis to bladder, vagina, or other pelvic organs. |
Surgery for cervical cancer1 | Conization which is a surgical excision of a cone shaped section of the abnormal cervical tissue best for pts that wish to have kids. |
Surgery for cervical cancer2 | If cervical lesions are easily visible laser, cryosurgery (freezing w/ liquid nitrogen), cauterization(burning) |
Metastasis cervical cancer | Total hysterectomy or radical pelvic surgery (which is if it has spread outside the repro tract, laparotomy may be done to stage the disease. |
Therapies done for cervical cancer | Radiation therapy, radium implants and chemotherapy. |
Things 2 assess for w/ cervical cancer1 | Spotting, post coital bleeding, foul smelling vaginal discharge, increased bloody discharge, wt loss, radiating pain to lower legs and back. |
Things 2 assess for w/ cervical2 | Abnormal pap w/ cellular changes w/ progression, wt loss, anemia. |
What is endometrial cancer | An overgrowth of mutated cells in the endometrial lining. |
Pf’s of endometrial cancer | Post menopausal women, estrogen replacement therapy for more than 5 yrs, nulliparous, Caucasian, middle class, no intercourse, jewish descent. |
S/S of endometrial cancer | Asymptomatic until advanced stages. |
Dx test used to diagnose endometrial cancer | Endometrial biopsy. |
Medical tx for endometrial cancer | Estrogen progesterone combination therapy |
Surgery for endometrial cancer | D & c (2 remove tumors). |
What is ovarian cancer | Overgrowth of mutated cells in the ovaries. |
Pf’s of ovarian cancer | 45-65yrs old, nulliparous, smoking, slcohol, infertility, high fat diet, breast cancer, family hx, possibly related 2 the presence of ovarian cysts ( may be @ higher risk for ovarian cancer). |
Ovarian cancer | Freq metastasizes before dx in colon, stomach, diaphragm. |
Dx test used to diagnose ovarian cancer | Bimanual exam, pelvic ultrasound, pelvic ct, ca-125 substance, lower gi, ivp, cxr, lapraroscopy, parcentesis w/ cytology. |
Med tx for ovarian cancer | Reoccurrence common: follow up q 2 mths for 2yrs, radiation. |
Surgical tx for ovarian cancer | Total abdominal hysterectomy wit bilateral sapinoophorecomy (removal of uterus ovaries, & fallopian tubes). |
Rx for ovarian cancer | Chemotherapy analgesics (pca or bromptons syrup), laxatives, tranqulizers antiemetics. |
Bromptons syrup | Contains syrup, cocaine, morphine, alcohol, flavoring, water. |
Things 2 assess for w/ ovarian cancer1 | Fatigue, diarrhea, constipation, pelvic pressure, frequency of urination, loss of appetite, nausea, wt loss, vaginal bleeding or spotting w/ intercourse. |
Things 2 assess for w/ ovarian cancer2 | Malaise, foul smelling vaginal discharge, pain in the lower back, health hx, reproductive hx, palpable mass, pap smear >11, abnormal biopsies. |
Things 2 assess for w/ ovarian cancer3 | Abnormal appearance, increased abdonminal girth, ascites, pleural effusion. |
What are the 5 menstruation disorders | Dysmenorrheal, amenorrhea, other(menorrhagia, metorrhagia, polymenorrhea), pms, comps of menopause. |
Dysmenorrhea | Painful menstruation(cramps) |
Causes of dysmenorrhea | Increased endocrine secretions, anatomical abnormalities, chronic illness, psych probs. |
Pf’s of dysmenorrhea | Nulliparous, no intercourse. |
Dx test for dysmenorrhea | Complaints, Pelvic exam,bimanual exam, ultrasound. |
Prevention of dysmenorrheal | Positive attitude toward menstruation. |
S/S of dysmenorrhea | Pelvic pain that can radiate before or at the onset of menstrual period caused by uterine spasms, narrowingof the cervical canal, emotional factors, Pid, Iud, endometriosis. |
Rx used for dysmenorrhea | Analgesics, prostaglandin inhibitors(helps control of pain), oral contraceptives. |
What is amenorrhea | Absence of menstruation. |
What are the 2 types of amenorrhea | Primary & secondary |
Primary amenorrhea | No menses by 17 y/o causes- anatomical or genetic abnormalities |
Secondary amenorrhea | 6 mths of normal menses & then stops or 12 mths of abnormal menses, then it stops. |
Causes of secondary amenorrhea | Anorexia nervosa, excessive exercise w/ decrease in body fat, endocrine dysfunction, emotional disturbances, s/e of meds, pregnancy, lactation, hormone imbalance, nutritional deficits, pituitary tumors. |
Dx test done for amenorrhea | Physical exam, pelvic exam, progesterone challenge test, serum prolactin. |
Menorrhagia | excessively heavy flow. |
Metorrhagia | Bleeding between periods. |
Polymenorrhea | Short cycles(<21 days). |
Oligomenorrhea | Decreased menstrual flow. |
Causes of Pom2(aka other menstrual d/o) | low dose bcp’s, metabolic d/o, hormonal d/o. |
Tx of Pom2 d/o | D & C, hysterectomy, blood transfusions, iron supplements. |
Things to assess for in Pom2 d/o | describe bleeding (onset, timing, number of pads, pain, clots), hx of meds, contraception, pregnancy, stressors, health probs, v/s & labs. |
Premenstrual syndrome(pms) | Group of s/s experienced during the secretory phase of the menstrual cycle. |
Pf’s of Pms | Stress, poor nutrion, rx or s/e from bcp, sedentary lifestyle, marital status, hx of preeclampsia, muliparity, and hormone imbalance. |
Dx test of Pms | Physical exam, keep calendar of s/s, labs to assess levels of: estrogen, progesterone, glucose. |
S/S of Pms | Has over 150 s/s, Onset 7-10 days before menses & ends w/ start of flow, wt gain, bloating, irritability, edema, ha, edema, mood swings, inability to concentrate, food cravings, acne. |
Rx for Pms | Tylenol, ibuprofen, naproxen, mifenamic acid, progesterone suppositories, last resort tranquilizers, antidepressants. |
Diet for Pms1 | Decrease: caffeine, dairy, chocolate, acidic foods, increase whole grains, nuts, pasta, herbal tea, legumes, root veggies, seafood, fruit. |
Diet for Pms2 | Vitamin supps w/ b complex vits, calcium, magnesium, zinc. |
Activity for Pms | Reg exercise, stress management, imagery, meditation, positive affirmation, visualization, acupressure, yoga, massage: neurovascular, neurolymphatic. |
Things to assess for in Pms | Wt, edema, labs, assess everything about all s/s. |
Complications of menopause (climacteric) cessation of menstruation | Cessation of menstruation |
Cause of menopause | Hormone decline |
Pf’s menopause | 45-60 y/o |
S/S of menopause | gradually inc. over 1 yr relaxation of pelvic support structures decrease in skin elasticity & turgor, thinning hair, vaginal dryness, thinning of vaginal mucosa, wt gain, dry skin, hot flashes, stress incontinence, inc risk for fractures, depression, in |
Rx for menopause | Estrogen replacement therapy: po, cream, or patch, keep ota for 10-15 secs before application given for 10-15 yrs after menopause, progesterone suppositories. |
Diet for menopause | Increase calcium, magnesium, decrease fat, vit e, primrose oil, calcium supps. |
Things to assess for in menopause | Hx of s/s, hx of menses, physical exam, pap smear. |
Cystocele | Downward displacement of the bladder into the anterior vaginal wall. |
Urethrocele | Downward displacement of the urethra into the vagina. |
Rectocele | Anterior displacement of the rectum into the posterior vaginal wall. |
Prolapsed uterus | Downward displacement of the uterus into the vagina. |
Cause of CURP | Multipariety 3rd to 4th degree perineal lacerations from child birth, weaking of the pelvic muscles from aging. |
Med tx for CURP | Decrease discomfort, restore structure & function. |
Pessary | A small, molded, plastic or rubbery apparatus that fits into the vagina to provide support for the uterus. |
Surgery for CURP | Prolapsed uterus |
Colporrhapy | Surgical narrowing of the vagine done vaginally to put bladder, urethra, or rectum back in place. |
MMK | Marshall, marchette, kranz, attaches the bladder to the inferior surface of the pubic bone. |
Things 2 assess for with CURP | Stress incontinence, frequency, urgency, constipation, childbearing hx, onset of s/s, ua w/ exam can visualize bulging of the bladder, urethra, or rectum into the vagina. |
Infertility | The inability to produce offspring. |
Cause of infertility | Endocrine, anatomic, or immune systems d/o, decreased progesterone levels can cause spontaneous abortion, cause spontaneous abortion. |
Infertility in couples | 40% female, 40% male, combo 20%. |
2 types of infertility | Primary-never been pregnant, secondary-inablity to conceive after having a child. |
Dx test for infertility | Do full workup after having tried to conceive for 6-12 mths, basal body temp chart for 3 mths 1st half cycle-<98 degrees, 2nd half of cycle >98 degrees, endometrial biopsy, laparoscopy, endocrine imbalance tests, artificial insemination. |
Artificial insemination | Place semen into the cervix or uterus w/ a small flexible catheter & syringe. |
In vitro fertilization1 | Gamete intra fallopian transfer- ovum & semen mixed in a catheter is injected into the fallopian tube. |
In vitro fertilization2 | Zygote Intra fallopian transfer or ivf-er (embryo transfer) several ova are mixed with sperm in a special fluid, wait 2-3 days, transfer fertilized ova into the fallopian tube. |
Rx for infertility | Fix hormone levels, hcg, progesterone suppositories, testosterone, thyroid extracts. |
Contraception | Prevention of pregnancy. |
Contraception consist of | Natural method, barriers, spermicides, Iud, hormonal methods, bcp. |
Natural method | Abstinence, rhythm method-no intercourse form 3 days before until 3 days after ovulation. |
Barriers | Block the path of sperm, diaphragm, cervical cap, male & female condoms. |
Spermicides | Kill sperm, work best in combination w/ barriers, do not use w/ apply @ least 15 mins before intercourse. |
Intrauterine device (Iud) | Device irriates the uterine cavity (dalcon shield), in place for 1-7yrs s/e, bleeding & infection. |
Hormonal methods | Oral contraceptives (bcp’s) suppress ovulation, make the body think that it is pregnant, 1:200 chance of pregnancy . |
Bcp’s contraindicated if | No established menstrual, cycle, htn, dm, cvd, thrombophlebitis. |
S/E of bcp | Ha, breast tenderness, nausea, wt gain, cva, thrombophlebitis. |
Norplant | Levonorgestrel 6 pellets inserted under the skin in the arm, works for 5 yrs. |
Depro Provera | Medroxyprofesterone acetate injection, IM q 12 wks suppresses ovulation, 3 weeks before effective s/e breakthrough bleeding. |
Sterilization | Tubal ligation- laparoscopy to tie fallopiantubes, generalor epidural, 30-60 mins, vasectomy- surgical resection of the vas deferns. |
Post op for vasectomy | Ice, rest, no strenuous activity, effective in 6 mths. |
Marshall, marchette, kranz, attaches the bladder to the inferior surface of the pubic bone. | |
Things 2 assess for with CURP | Stress incontinence, frequency, urgency, constipation, childbearing hx, onset of s/s, ua w/ exam can visualize bulging of the bladder, urethra, or rectum into the vagina. |
Infertility | The inability to produce offspring. |
Cause of infertility | Endocrine, anatomic, or immune systems d/o, decreased progesterone levels can cause spontaneous abortion, cause spontaneous abortion. |
Infertility in couples | 40% female, 40% male, combo 20%. |
2 types of infertility | Primary-never been pregnant, secondary-inablity to conceive after having a child. |
Dx test for infertility | Do full workup after having tried to conceive for 6-12 mths, basal body temp chart for 3 mths 1st half cycle-<98 degrees, 2nd half of cycle >98 degrees, endometrial biopsy, laparoscopy, endocrine imbalance tests, artificial insemination. |
Artificial insemination | Place semen into the cervix or uterus w/ a small flexible catheter & syringe. |
In vitro fertilization1 | Gamete intra fallopian transfer- ovum & semen mixed in a catheter is injected into the fallopian tube. |
In vitro fertilization2 | Zygote Intra fallopian transfer or ivf-er (embryo transfer) several ova are mixed with sperm in a special fluid, wait 2-3 days, transfer fertilized ova into the fallopian tube. |
Rx for infertility | Fix hormone levels, hcg, progesterone suppositories, testosterone, thyroid extracts. |
Contraception | Prevention of pregnancy. |
Contraception consist of | Natural method, barriers, spermicides, Iud, hormonal methods, bcp. |
Natural method | Abstinence, rhythm method-no intercourse form 3 days before until 3 days after ovulation. |
Barriers | Block the path of sperm, diaphragm, cervical cap, male & female condoms. |
Spermicides | Kill sperm, work best in combination w/ barriers, do not use w/ apply @ least 15 mins before intercourse. |
Intrauterine device (Iud) | Device irriates the uterine cavity (dalcon shield), in place for 1-7yrs s/e, bleeding & infection. |
Hormonal methods | Oral contraceptives (bcp’s) suppress ovulation, make the body think that it is pregnant, 1:200 chance of pregnancy . |
Bcp’s contraindicated if | No established menstrual, cycle, htn, dm, cvd, thrombophlebitis. |
S/E of bcp | Ha, breast tenderness, nausea, wt gain, cva, thrombophlebitis. |
Norplant | Levonorgestrel 6 pellets inserted under the skin in the arm, works for 5 yrs. |
Depro Provera | Medroxyprofesterone acetate injection, IM q 12 wks suppresses ovulation, 3 weeks before effective s/e breakthrough bleeding. |
Sterilization | Tubal ligation- laparoscopy to tie fallopiantubes, generalor epidural, 30-60 mins, vasectomy- surgical resection of the vas deferns. |
Post op for vasectomy | Ice, rest, no strenuous activity, effective in 6 mths. |