ATI Proctored OB Maternal Newborn Study Guide.

Video #1: Contraception & Infertility Diaphragms: client must be refitted for a diaphragm for the following conditions: 1. It’s been 2 years since she has been fitted 2. Gained more than 15 pounds (7kg) 3. Had a full-term pregnancy 4. Had a second term abortion o When you use a diaphragm, you need to use spermicide with every act of coitus (withdrawal of penis from vagina prior to ejaculation). Every time you withdrawal, instill more spermicide. o Diaphragm must stay inserted for 6hrs after act of coitus. Hormonal Contraceptives (Oral) o Side effects: Chest pain, SOB, Leg pain (from a possible clot), headache or eye problems (from a stroke or hypertension) o Contraindications: Women with a history of blood clots, stroke, cardiac problems, smoker, breast or estrogen related cancers (pill contains estrogen) Depo-Provera/Medroxyprogesterone o Injectable progestin o Can cause decreased bone mineral density or loss of calcium ▪ Nursing action: Ensure patient has adequate intake of calcium and vitamin D IUD o Increase risk for PID o Can cause uterine perforation or ectopic pregnancy (increases risk for ectopic pregnancy) o Look out for/Notify PCP: ▪ Change in string length →IUD is moving and not in the right place ▪ Foul smelling vaginal discharge ▪ Pain with intercourse ▪ Fever/Chills (infection) Infertility is defined as an inability to conceive desire engaging in unprotected sexual intercourse for a prolonged period of time or at least 12 months. Common factors associated with infertility include: o Decreased sperm production (Sperm analysis) o Endometriosis o Ovulation disorders o Tubal occlusions →If you test and use DYE (used in the fallopian tubes), make sure the woman is not allergic to iodine or shellfish/seafood