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1. breast self examination (BSE): Start in the 20's
5-7 (maybe 10) days after menstruation
1. Supine position
2. RT arm behind head
3. Opposite hand - pads of 3 middle fingers
4. Dime-sized circular motions
Light, medium, & firm pressure
Repeat step 4, Up and down
Pressing down on hips contracts chest muscles and enhances breast changes
2. Mammography Screening: X-ray of the breast tissue to detect abnormal growths
Screening tool
3. MRI (magnetic resonance imaging): Noninvasive nuclear procedure is espe-
cially useful in women with an inherited susceptibility to breast cancer
NOT a substitute for a mammogram
Screening tool
4. Clinical Breast Exam (CBE): Should be performed annually
Annual screening after age 40
Screening tool
5. Breast Cancer: African American women are at a lower risk than Caucasian
women
6. If a patient finds a breast lump, how should the nurse advise her?: Feeling a
lump is never normal! Have the PT F/U to do further testing!
Breast tissue thickens during pregnancy
Endometrial lining also thickens
7. Emergency Contraceptive Pills (ECP): Can be used up to 72 hrs after inter-
course
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Three types:
1. Combined ECPs (contain both estrogen & progestin)
2. One-dose progestin-only ECPs such as Plan B One-Step
3. A one-dose ECP that contains an anti progestin (Ella)
Progestin-only ECPs are most common - Fever S.E. & more effective
** ECPs do NOT cause abortion or harm an established pregnancy
Can delay ovulation, teach PT to use backup contraception
8. IUD (intrauterine device): Indications:
1. Nullipara
2. Adolescents
3. Hx of ectopic pregnancies
4. Lactating women
5. Women w/+ HIV test
6. Immediately post 1st trimester abortion
Preparations:
1. - Pregnancy test
2. Tx for dysplasia
3. Eval for abnormal uterine bleeding
4. Cervical cultures to rule out STIs
5. CONSENT FORM
Risks
1. High rate of ectopic pregnancies in tubal ligation procedures that fail
9. Sterilization: Permanent & irreversible
Requires informed consent
Types:
1. Bilateral tubal ligation (BTL): Best performed within 48 hrs of vaginal birth or during
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cesarean birth
Hysterosalpingogram is a dye test performed at 3 months, after procedure, to
confirm tubal patency
10. Vasectomy: Performed under local anesthesia & involves a small incision in the
scrotum
Interrupts the passage of sperm into the seminal fluid
Semen no longer contain sperm
11. Depo-Provera: Medroxyprogesterone acetate
Bone mass may be adversely affected (Length of use may contribute to loss of bone
mass)
Educate PT must take calcium and vitamin D to prevent bone loss while on
Depo-Provera
Do not forget: Weight-bearing exercises also help!
Weight gain can be expected
Q 12 wks
12. Cervical Cap: Placed directly over the cervix
1/3 of cap is filled with spermicide, also applied to outside of cap
Inserted up to 6 hrs before intercourse & should be kept in for up to 6 hrs after the
last intercourse
Should never be in place for longer than 48 hrs
Remove by rotating the device & pushing tip of finger against the dome to break the
suction
Cap should be washed with soap & water & stored in a dry cool place.
13. Condoms: W/O reservoir tip, leave small space at the end
Natural skin condos do NOT protect against HIV & STIs