NURS 621: ADULT/GERO. 1 - EXAM 4 STUDY GUIDE ON FAMILY PLANNING & GYNECOLOGY ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

NURS 621: ADULT/GERO. 1 - EXAM 4
STUDY GUIDE ON FAMILY
PLANNING & GYNECOLOGY
ACTUAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)

,NURS 621: Adult/Gero. 1 Spring 2021
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Exam 4 Study Guide Family Planning • Gynecology
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FAMILY PLANNING iv




CONTRACEPTIVE ISSUES iv


 Half of yearly pregnancies are unintended; half of those pregnancies end in abortion
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 No contraceptive method is 100% effective Ini
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tial Patient Evaluation
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 Medical history (any RFs for pregnancy or previous/current contraception)
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o HTN, BM, obesity iv iv


 OB/GYN history
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o Risk for STI; hx of BC methods iv iv iv iv iv iv


o Sexual dysfunction/concerns iv


o Health promotion/safe sex practices iv iv iv


o Menstrual cycle, Previous pap tests iv iv iv iv


 Physical Exam
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o Pap smear iv


o Wet mount (if any irregular discharge) iv iv iv iv iv


o GC/Chlamydia test, HIV, Syphilis iv iv iv


o Cigarette, Alcohol, Drug use/abuse iv iv iv




CONTRACEPTIVE METHODS iv


 No protection/ Chance: failure rate 85%
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 Coitus Interruptus: failure rate 27%; advantages (no artificial barriers, chemicals or devices)  Fertility Aw
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areness Method: failure rate 25%; periodic abstinence, basal body temperature/cervical mucus changes
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BARRIER METHODS—condoms, foams, suppositories, sponge, films, gels, diaphragm
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 Failure rate 20%
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 Protect against pregnancy and STIs
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 Available OTC
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 May cause allergic reaction and can be messy
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 **Nonoxyl-9 (spermicide) may increase transmission of STIs including HIV**
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SPERMICIDES—foams, gels, sponge, films, suppositories iv iv iv iv


 Failure rate 20-50%
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 Must be inserted correctly
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 No more than one hour before intercourse
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 Additional application if one hour has passed since insertion
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 One application per one act of intercourse
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 Leave in place for 6 hours
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CONDOMS
 #1 barrier against STIs/HIV
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 Use water-based lubricants (oil-based will break down latex)
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DIAPHRAGM
 Use with spermicide cream/jelly
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 Must be fitted for correct size refit after significant weight change +/- 10 lbs and after childbirth
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 Insert up to 6 hours before and leave in 6 hours after intercourse for effectiveness
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HORMONAL METHODS—BC pills, patch, injections, implants, IUD, ring
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Do NOT protect from STIs or HIV
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Failure rate 1-5% (when used correctlDyo)wnloaded by Wambo Jeni ()
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, Oral Contraceptive Pills (OCPs)
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 Combination Pill—Estrogen/Progestin
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o 28 pill pack—3 weeks active; 1 week sugar pill iv iv iv iv iv iv iv iv


o Relatively inexpensive; covered by many insurances 100% iv iv iv iv iv iv


o Can be stopped at any point iv iv iv iv iv


o Regular cycle, help with acne iv iv iv iv


o Ovcon, Ortho Tri-Cyclen iv iv


 3-Month Oral Pill iv iv iv


o Combination estrogen/progestin iv


o 11 weeks active pill; 1 week sugar pill iv iv iv iv iv iv iv


o Cycle every 3 months iv iv iv


o Good for women with dysmenorrhea or menorrhagia iv iv iv iv iv iv


o Increased risk breakthrough bleeding iv iv iv



Action Benefits Side Effects
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● Inhibits ovulation iv ● Prevent pregnancy iv CVA, MI, thromboembolic
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● Thins endometrium iv ● ↓mens flow, iv events N/V, HA, dizziness,
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● Thickens cervical cramps, PMS sx; i v iv edema
mucus ●MUST take at iv iv iv improve acne iv ↑ appetite, fatigue,
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the same time each i v i v ● Protect against depression, oily skin, yeasti v iv iv


day endo/OV CA, OV cysts, i v iv iv infection, break through
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ectopic preg. ●Protect i v i v bleeding/spotting
against PID iv Decrease action of Abx.iv iv iv


● Safe >35 if non-
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smoker ●Menst. iv


Cycle controliv




Missed Pill Scheduling iv iv


 1 pill: take as soon as rem
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ember; may take 2 in one day iv iv iv iv iv iv

 2+ pills: take most recent
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missed pill ASAP; no more tha iv iv iv iv iv

n 2 pills in one day; continue r
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est of pack as usual
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 Backup contraception until 7 day
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s of no missed pills
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Must take pill daily for 99% Injectab
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le Progestin—
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Depo Provera effectiveness iv iv


 Depo Provera 150mg IM every 12 weeks  Deltoid or gluteus maximus
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 Disadvantages: prolonged bleeding or amenorrhea, weight gain, hair loss, in
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creased calcium loss iv iv


 No protection form STIs
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Implantable Progestin—Nexplanon iv

 Upper arm
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 Remove after 3 years
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 Contraindications: pregnancy, DVTs, liver disease, breast CA, unexplained bleeding Proge
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stin only (mini) Pill
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Use if estrogen is contraindicated U
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se if breastfeeding
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SE: irregular vaginal bleeding, poor cycle control
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