ATI Capstone Maternal Newborn Study Guide

ATI Capstone Maternal Newborn Chapter 1- contraception • Contraception refers to strategies or device used to reduce the risk of fertilization or implantation in an attempt to prevent pregnancy • Natural family planning: behavioral methods o Abstinence – no gentialia contact o Withdrawal (coitus interruptus)  Choice for monogamous couple  Least effective methods  Risk for pregnancy o Calendar methods  ovulation occurs about 14 days before the onset of her next menstrual cycle, and avoid intercourse during that period  count at least 6 cycles o basal body temperature  body temperature can drop slightly at the time of ovulation  measure oral temperature prior to getting out of bed each morning to monitor ovulation  inexpensive, convenient, and no adverse effects  Basal body temperature and the symptothermal method are fertility awareness methods. o Lactational amenorrhea method • Barrier o Condoms  Only water-soluble lubricants should be used with latex condoms to avoid condom breakage o Diaphragm  Dome-shaped cup with a flexible rim made of silicon that fits snugly over the cervix with spermicidal cream or gel placed into the dome and around the rim  Client should be properly fitted with a diaphragm by a provider  Replaced every 2 years and refitted for a 20% weight fluctuation, after abdominal or pelvic surgery and after every pregnancy  Prior to coitus, the diaphragm is inserted vaginally over the cervix with spermicidal jelly or cream that is applied to the cervical side of the dome and around the rim  The diaphragm can be inserted up to 6 hours before intercourse and must stay in place 6 hour after intercourse but for no more than 24 hrs.  Spermicide must be reapplied with each act of coitus  Patient should empty bladder before insertion  Wash with soap and water after use o Cervical cap o Contraceptive sponge o Question  Which method would the nurse identify as a barrier method of contraception? a. Basal body temperature b. Transdermal patch c. Diaphragm d. Symptothermal method • Hormonal o Oral contraceptives  Adverse effect • Chest pain, shortness of breath, leg pain from a possible clot, headache, eye problems form a stroke, and hypertensive, breast tenderness, nausea, breakthrough bleeding (common adverse effects of estrogen component and progestin component)  Can increase the risk of thromboembolism, stroke, heart attack, hypertension, gallbladder disease, liver tumor  Effectiveness decrease when taking medications that affect liver enzymes, such as anticonvulsants and some antibiotics o Injectable contraceptives  Medroxyprogesterone is an IM or SQ injection given to a female client every 11 to 13 weeks • First injection should be during the first 5 days of period • In postpartum, 5 days after delivery  Maintain adequate intake of calcium and vitamin D  Very effective and require only 4 injections per year  Adverse effects • Decrease in bone mineral density, weight gain, increase depression and irregular vaginal spotting or bleeding  Contraindicated for osteoporosis patient  Return to fertility can be a long as 18 months after discontinuation o Transdermal patches