ATI Proctored OB Maternal Newborn Study Guide Graded A

 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