NUR 421 EXAM 1 VERIFIED STUDY GUIDE
AWHONN's position on insurance and contraception and contraception - Answers -
AWHONN - Association if women's health, obstetric, and neonatal nurses
They support the inclusion of all contraceptive drugs, devices (including device
insertion), and related services that are approved by the U.S. Food and Drug
Administration as covered health insurance benefits in public and private plans.
AWHONN considers access to widespread, affordable, and acceptable health car,
which includes safe and reliable contraceptives to be a basic human right
IUD - Answers - 98-99% effective (hormonal → progesterone, copper)
~Progesterone IUD is long acting and slowly releases progesterone which thins the
lining of the uterus so the egg can't implant. Can last from 3-7 years. Side effects
include expelling/perforate, ectopic pregnancy, spotting, irregular menstrual cycle for 3-
6 months,
~Copper IUD can last for 10 years, someone with copper allergy should not use this.
Could make menstrual cycle heavier and stays regular, more cramping, → Should avoid
in women who have been diagnosed and treated for pelvic inflammatory disease (PID)
within 3 months
~All IUDs are forgettable contraception
Nexplanon - Answers - 99% (progesterone) → 3 years
~Thickening mucus in uterus and thinning of the lining in the uterus, may inhibit release
of egg
~Side effects, irregular/unpredictable menstrual cycles, and spotting
~Don't use on women with BMI over 35
Depo - Answers - 97% (progesterone shot every 12 weeks)
~Same progesterone
~Has to go in to get the shot every 12 weeks, has to stop for up to a year if you want to
get pregnant,
~Irregular bleeding at first then no bleeding at all, weight gain more with relation to BMI,
decreased bone density - calcium, weight bearing activities, and vitamin D
~People with a high BMI, and transportation issues should not use depo
Combined Oral Contraceptive - Answers - 91% (estrogen and progesterone)
~Works to delay the feedback system and stop releasing an egg. Does not allow
luteinizing hormone surges and tricks your body to think you're pregnant. Thick mucus,
thinning lining.
~Sloughing of the lining, it's not an actual period
~People who have hypercoagulability shouldn't use this method with estrogen since it
also coagulates (COVID, smokers, factor 5)
, ~active cancer, over 35/smoke, dvt, htn, heart disease, factor 5, --> heart disease,
strokes, blood clots
~Nausea, headaches, spotting weight gain, breast tenderness, and chloasma
One Hormone Mini Pill - Answers - 90%
~Progesterone effects (thickens mucus and thins lining)
~Take it at the same time every day, within the hour
~Well tolerated, over the counter in europe, canada, etc..,
Weight gain, irregular bleeding, nausea, mood changes, doesn't prevent STI's
Condoms/Spermicides - Answers - less effective 80-85%
Side effects include irritation, allergy, urinary tract infection.
Withdrawal - Answers - less effective 80-85%
Phexxi - Answers - ~Ph change that affects sperm motility
~Needs to be implanted in a hour before sex
~Cream implanted in vagina
● Ingredients: lactic acid, citric acid and potassium bitartrate
● Dosage and info: Use one prefilled syringe up to one hour prior to intercourse. Repeat
for each act of intercourse. Can be used at any part of menstrual cycle.
● Do not use if person suffers from recurrent UTI or Urinary tract abnormalities
● Mechanism of Action:ph lowering effect in vagina/ therefore decreased sperm motility
Fertility Awareness - Answers - less effective 80-85%
~Basal body temperature, tracking ovulation, and not having sex during ovulation,
checking cervical mucus (know your cycle and track for 6 months)
~Lots of client education
Nuva ring - Answers - 9% failure
estrogen and progesterone
~People who have hypercoagulability shouldn't use this method with estrogen since it
also coagulates (COVID, smokers, factor 5)
~Vaginal discharge/irritation, side effects similar to Oral contraceptives
Patch - Answers - 9% failure
estrogen and progesterone
~People who have hypercoagulability shouldn't use this method with estrogen since it
also coagulates (COVID, smokers, factor 5)
New one every week for 3 weeks, then remove for one
~Less effect on larger women, same risks as oral contraceptives, skin irritation,
Annovera - Answers - 9% failure
combined hormonal contraceptive vaginal ring
estrogen and progesterone
AWHONN's position on insurance and contraception and contraception - Answers -
AWHONN - Association if women's health, obstetric, and neonatal nurses
They support the inclusion of all contraceptive drugs, devices (including device
insertion), and related services that are approved by the U.S. Food and Drug
Administration as covered health insurance benefits in public and private plans.
AWHONN considers access to widespread, affordable, and acceptable health car,
which includes safe and reliable contraceptives to be a basic human right
IUD - Answers - 98-99% effective (hormonal → progesterone, copper)
~Progesterone IUD is long acting and slowly releases progesterone which thins the
lining of the uterus so the egg can't implant. Can last from 3-7 years. Side effects
include expelling/perforate, ectopic pregnancy, spotting, irregular menstrual cycle for 3-
6 months,
~Copper IUD can last for 10 years, someone with copper allergy should not use this.
Could make menstrual cycle heavier and stays regular, more cramping, → Should avoid
in women who have been diagnosed and treated for pelvic inflammatory disease (PID)
within 3 months
~All IUDs are forgettable contraception
Nexplanon - Answers - 99% (progesterone) → 3 years
~Thickening mucus in uterus and thinning of the lining in the uterus, may inhibit release
of egg
~Side effects, irregular/unpredictable menstrual cycles, and spotting
~Don't use on women with BMI over 35
Depo - Answers - 97% (progesterone shot every 12 weeks)
~Same progesterone
~Has to go in to get the shot every 12 weeks, has to stop for up to a year if you want to
get pregnant,
~Irregular bleeding at first then no bleeding at all, weight gain more with relation to BMI,
decreased bone density - calcium, weight bearing activities, and vitamin D
~People with a high BMI, and transportation issues should not use depo
Combined Oral Contraceptive - Answers - 91% (estrogen and progesterone)
~Works to delay the feedback system and stop releasing an egg. Does not allow
luteinizing hormone surges and tricks your body to think you're pregnant. Thick mucus,
thinning lining.
~Sloughing of the lining, it's not an actual period
~People who have hypercoagulability shouldn't use this method with estrogen since it
also coagulates (COVID, smokers, factor 5)
, ~active cancer, over 35/smoke, dvt, htn, heart disease, factor 5, --> heart disease,
strokes, blood clots
~Nausea, headaches, spotting weight gain, breast tenderness, and chloasma
One Hormone Mini Pill - Answers - 90%
~Progesterone effects (thickens mucus and thins lining)
~Take it at the same time every day, within the hour
~Well tolerated, over the counter in europe, canada, etc..,
Weight gain, irregular bleeding, nausea, mood changes, doesn't prevent STI's
Condoms/Spermicides - Answers - less effective 80-85%
Side effects include irritation, allergy, urinary tract infection.
Withdrawal - Answers - less effective 80-85%
Phexxi - Answers - ~Ph change that affects sperm motility
~Needs to be implanted in a hour before sex
~Cream implanted in vagina
● Ingredients: lactic acid, citric acid and potassium bitartrate
● Dosage and info: Use one prefilled syringe up to one hour prior to intercourse. Repeat
for each act of intercourse. Can be used at any part of menstrual cycle.
● Do not use if person suffers from recurrent UTI or Urinary tract abnormalities
● Mechanism of Action:ph lowering effect in vagina/ therefore decreased sperm motility
Fertility Awareness - Answers - less effective 80-85%
~Basal body temperature, tracking ovulation, and not having sex during ovulation,
checking cervical mucus (know your cycle and track for 6 months)
~Lots of client education
Nuva ring - Answers - 9% failure
estrogen and progesterone
~People who have hypercoagulability shouldn't use this method with estrogen since it
also coagulates (COVID, smokers, factor 5)
~Vaginal discharge/irritation, side effects similar to Oral contraceptives
Patch - Answers - 9% failure
estrogen and progesterone
~People who have hypercoagulability shouldn't use this method with estrogen since it
also coagulates (COVID, smokers, factor 5)
New one every week for 3 weeks, then remove for one
~Less effect on larger women, same risks as oral contraceptives, skin irritation,
Annovera - Answers - 9% failure
combined hormonal contraceptive vaginal ring
estrogen and progesterone
