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Female repro

2nd semester 2009 program

Question	Answer
What are the 2 assessments done for females	Breast & Genitalia.
What do u assess in the breast exam	Nipples 4 drainage, cracking, edema, redness…Tissue do self exam, lungs.
What do u assess in the genitalia	have 2 people room, assess pubic hair texture is it the same no bald spots & no lice, skin no lesions look 4 tears, external structures, speculum exam.
Pelvic inflammatory disorders	inflammation from pathogens in the fallopian tubes or ovaries or both, may involve other structures except uterus spreads upward.
What 3 things cause Pid	Streptococcus, staphylococcus, gonococcus.
What PF contribute to Pid	Freq intercourse, multiple sex partners, Iud’s & child birth.
Pid complications	Peritonitis, pelvis abcess, infertility, ectopic pregnancy.
Peritonitis	Inflammation of peritoneum membrane covering the abd.
S/S of Pid(faboslnd)	Low temp, pelvic abd pain, foul discharge, n/v, dysmenorrheal, dyspareunia, oophoritis, salpingitis.
Salpingitis	inflammation of fallopian tubes.
Oophoritis	inflammation of ovaries.
Dyspareunia	painful intercourse.
Dysmenorrhea	painful menstruation
3 Dx test	Pelvic exam,vaginal & cervical c&s, ultrasound.
Meds for Pid	D5LR or LR, antibiotics, vaginal suppositories.
Surgery for Pid	Hysterectomy or removal of uterus.
Things 2 assess 4 for Pid	Sex activity, # of partners, hx of contraception, prev vag infects, prev med tx, hygiene pract, increased temp, dry flushed skin, vag discharge, vag & cerv c&s.
Endometriosis	growth of endometrial cells growing outside of the uterus in the pelvis.
How many Rf does endometriosis have	3, 30yrs or older, familial, Caucasian women
S/S of Endometriosis	occur monthly not correlated w/ the severity of the disease: low backache, dyspareunia, heavy feeling in pelvis, spotting.
Complications of Endo	Scar tissue, adhesions, infertility.
Dx test for endo	Palpation pelvic exam & laparoscopy.
Laparoscopy	Exam of internal pelvis structurs by direct visualization w/ laparoscope general anesthesia is used.
Med tx for endo	based on age & desire for child bearing, pregnancy may help relieve symptoms.
Surgical tx for endo	Hysterectomy, laparotomy(cauterization, lysis, laser vaporization)
Rx goals for endo	Decrease s/s, reduce ovulation/menst., shrink implants
Rx used for endo	oral contraceptives continuously, nafarelin acetate nasally inhibits cyclic hormone release, Danazol inhibits release of gonadotropian, results in amenorrhea supports growth of end tissue.
Endo Rx se’s	oily skin, wt gain, fluid restricition, acne, hot flashes, metorrhagia, mastalgia, depression.
Metorrhagia	breakthrough bleeding
Mastalgia	Pain in breast.
Things 2 look for in a pt wit endometriosis	pain, prolonged excessive menstruation, dyspareunia, pain with defecation.
What is vaginitis	Inflammation of the vagina.
What causes vaginitis	Bacteria, gardnerella, streptococcus, staphylococcus, herpes simplex 2, chlymadia trachomatis.
What are the 5 common types of vaginitis	Candidiasis albicans(yeast), trichomonasis, gardnerella, chlymadia, post menopausal vaginitis.
Pf’s of yeast	Obesity, pregnancy, douching, dm, abt’s, oral contraceptives.
S/s of yeast	Irritation, burning, white patches in vagina, redness, edema, discharge, itching, thick white, cheesy curd like discharge w/musty odor.
Med tx for yeast	Douche w/ white vinegar solution bid x 1 week, apply yogurt to labia (acidophilus), antifungal creams/suppositories for 7 days
Antifungal creams for treating yeast	Miconazole, clotrimazole, nystatin.
Cause of trichomonasis infection	Intercourse.
S/s of trichomonasis	Itching, burning, green/yellow foul smelling frothy discharge.
Med tx for Trichomonasis	Flagyl taken by mouth for both partners.
S/S of Gardenerella infection	Asymptomatic, strong, fishy odor, itching & burning.
Med tx for Gardenerella	Oral Abt: tetracycline hcl, ampicillin, flagyl, sulfa creams: sultrin, triple sulfa, antiviral creams qd or bid for 6-14 days.
Chlymadia	s/s are asymptomatic. Complications are infertility.
What dx test is done to diagnose chlymadia	Vaginal c & S.
Med tx for chlymadia	Oral abt for 7 days & then repeat c & s.
What causes postmenopausal vaginitis	Decreased estrogen levels.
S/S of postmenopausal vaginitis	Dyspareunia, irritation, burning and itching.
Med tx for postmenopausal vaginitis	Estrogen replacement: po, patch(transdermal), and vaginal.
Teaching for postmenopausal vaginitis	Wear cotton panties, do not sit in wet bathing suit in warm weather, treat quickly, 8 oz of yogurt po qd w/ abt.
Things 2 assess 4 in postmenopausal vaginitis1	Bubble baths, panty hose, type of panties, hx of s/s, hx of menses, contraceptive methods, abt use
Things 2 assess 4 in postmenopausal vaginitis2	recent illness, sexual hx, Dm, usual hygiene, pregnancy hx, use of deodorant tampons or pads, c,c,a,o of discharge, scratches, irritation.
What is toxic shock syndrome(tss)	A condition most associated w/ staph
Cause of Tss	Staphylococcus aureus.
Pf’s of tss	Tampon use, women under 30 yrs old.
S/s of tss	Temp of 102 or greater, vomiting, diarrhea, flulike s/s malaise, muscle weakness, sore throat, and headache, macular erythematous rash (red, flat) followed in 1-2 wks by peeling of the palms & soles, dehydration, disorientation.
Med tx of tss	Iv fluids, mechanical ventilation, Cpap used to force O2 in to the lungs.
Dx test for tss	C & S for staph: in blood, urine, throat.
Med tx for tss	Treat hypotension, stop infection, maintain ventilation, fluid volume replacement, encourage Iv fluids.
Things 2 assess for w/ tss	Tampon use: freq of change duration of use, sore throat, ha, myalgia, fatigue, erythematous rash, edema, peeling of the palms & soles, hypotension Loc, nonpurulent conjunctivitis, hyperemia of the vagina and oropharynx.
What are 2 types of benign neoplasms	Fibrocystic breast disease & fibroid tumors.
What is fibrocystic breast disease	Hyperplasia of the epithelial cells leads to an icrease in fibrous tissue aka chronic cystic mastitis or lumpy breast syndrome.
What are the causes and pf’s of fbd	Unknown, caffeine.
S/s of fbd	Yellowish greenish sticky discharge from nipples.
Hyperplasia	Over growth is the # of the cells.
Hypertrophy	Over growth in the size of cells.
Dx test used to diagnose fbd	Mammogram, bse pap smear on nipple discharge, biopsy (will tell if tumors are present either benign or malignant.
Benign	not a threat to life or long-term health especially by being noncancerous.
Malignant	Likely to cause harm or death cancerous.
Surgery for fbd	Aspiration or incision to excise the tissue
Rx used for fbd	Vit e qd
Things to assess in fbd	Most recent mammogram, caffeine intake freq of bse, increased pain in lumps w/ menses, moveable lumps on breast exam.
What is fibroid tumors leiomas	An overgrowth of cells in & around the uterus.
What are the pf’s of fibroid tumors leiomas	Older than 30 yrs old & nulliparous.
Nulliparous	Never having delivered infant after 24 wks gestation.
S/s of fibroid tumors leiomas	Menorrhagia, increasing pelvic, pressure, dysmenorrheal, abdominal enlargement (b/c the fibroids are growing), constipation.
Complications of fibroid tumors leiomas	Preterm delivery, fast growth (spreads & takes up a lot of space).
Medical tx and surgery 4 fibroid tumors leiomas	Observe growth, myomectomy, d & c, & hysterectomy.
Myomectomy	Surgical removal of uterine fibroids from the uterus.
Diet for fibroid tumors leiomas	High in iron.
Things 2 assess 4 in fibroid tumors leiomas	Ask about s/s, # of sanitary pads used in an hour, clots in menses, decreased hct, pale, hypotension, tachycardia.
What is breast cancer	An overgrowth of mutated cells in the breast tissue. 2nd leading cause of death in women.
Pf’s of breast cancer	Late menopause, onset of menses before 10y/o, high fat diet, moderate alcohol intake, smoking, over 65 y/o family hx, nulliparous, 1st pregnancy after 30y/o, hx fibrocystic breast disease obesity, never having breast fed, <1% of men.
Dx test done to diagnose breast cancer	Pe, mammogram, bse.
Stage 1 of breast cancer	Tumor smaller than 2cm, no lymph nodes test + for cancer cells, no evident metastases.
Stage 2 of breast cancer	Tumor is between 2 & 5cm, 0-1 lymph nodes test + for cancer cells, no evident metastases.
Stage 3 of breast cancer	Tumor is larger than 5 cm no lymph nodes test + for cancer cells/ no evident metastases or tumor is between 0 & 5 cm & lymph nodes test positive for cancer cells with no evident metastases.
Stage 4 of breast cancer	Tumor is of any size, lymph nodes may/may no test + for cancer cells, evident metastases into other areas lungs, bone, brain, liver.
s/s of breast cancer	Painless mass or thickening lump, pain or discharge from the nipple, unilateral change in breast size, dimpling or puckering orange peel appearance, microclusters tiny palpable clusters of calcium that feel like rocks
Prevention of breast cancer1	20-40y/o-bse q mo, clinical bse q 3-4yrs
Prevention of breast cancer2	41-49 y/o-bse q mo, clinical bse q 1-2 yrs, mammogram q 1-2 yrs
Prevention of breast cancer3	50 yrs and up all above q 1yr
Prevention of breast cancer4	Tamoxifen helps prevent growth of tumors is given to high risk pts.
Medication for breast cancer	Radiation & chemo
Surgery for breast cancer	Lumpectomy, simple mastectomy, modified mastectomy, radical mastectomy.
Lumpectomy	Surgical removal of tumor.
Simple mastectomy	Removal of the tumor & a small portion of breast tissue.
Modified mastectomy	Removal of the entire breast and nearby lymph nodes.
Radical mastectomy	Removal of the entire breast, lymph nodes and underlying pecoralis muscle.
Post op care for breast cancer surgery	Do not carry anything on affected side including a purse, do not draw blood, get shots or take bp on affected side, always wear med alert tag, may get prosthesis or reconstruction done.
Rx for breast cancer pts	Antieoplastics: antiestrogens, androgens, alkalating agents, antitumor antibiotics, antimetabolites, steroids used in combo before or after or.
Things 2 assess for in breast cancer	Lumps, discharge from nipples, unilateral changes, how longs, tender or non painful, less w/ menstrual cycle, last mammogram, v/s, wt, bse, last mammogram check, check s/s.
Things 2 assess post op for breast cancer	v/s, incision, check emotional needs.
What is cervical cancer	An overgrowth of mutated cells in the cervix of the uterus.
Dysplasia	An early stage of the cancer a change in the size or shape of the cervical cells classified as mild, moderate or severe.
Dx test for cervical cancer	Abnormal pap smear classified from 1 thru 5. 1 is considered normal 5 indicates a malignant condition.
Pf’s of cervical cancer	Multiple sexual partners, hpv 35-55y/o, maternal use of dithylstibestrol during pregnancy.
S/s of cervical cancer	Initially asymptomatic, abnormal bleeding, thin watery progressing to bright red, contact bleeding after intercourse, odor, pain in the lower back & groin, difficulty voiding, hematuria, rectal bleeding.
Med tx of cervical cancer	Antibiotic cream or colposcopy followed by repeat pap depends on staging.
Cervical stage 1	No spread only on the cervix.
Cervical stage 2-5	Metastasis to bladder, vagina, or other pelvic organs.
Surgery for cervical cancer1	Conization which is a surgical excision of a cone shaped section of the abnormal cervical tissue best for pts that wish to have kids.
Surgery for cervical cancer2	If cervical lesions are easily visible laser, cryosurgery (freezing w/ liquid nitrogen), cauterization(burning)
Metastasis cervical cancer	Total hysterectomy or radical pelvic surgery (which is if it has spread outside the repro tract, laparotomy may be done to stage the disease.
Therapies done for cervical cancer	Radiation therapy, radium implants and chemotherapy.
Things 2 assess for w/ cervical cancer1	Spotting, post coital bleeding, foul smelling vaginal discharge, increased bloody discharge, wt loss, radiating pain to lower legs and back.
Things 2 assess for w/ cervical2	Abnormal pap w/ cellular changes w/ progression, wt loss, anemia.
What is endometrial cancer	An overgrowth of mutated cells in the endometrial lining.
Pf’s of endometrial cancer	Post menopausal women, estrogen replacement therapy for more than 5 yrs, nulliparous, Caucasian, middle class, no intercourse, jewish descent.
S/S of endometrial cancer	Asymptomatic until advanced stages.
Dx test used to diagnose endometrial cancer	Endometrial biopsy.
Medical tx for endometrial cancer	Estrogen progesterone combination therapy
Surgery for endometrial cancer	D & c (2 remove tumors).
What is ovarian cancer	Overgrowth of mutated cells in the ovaries.
Pf’s of ovarian cancer	45-65yrs old, nulliparous, smoking, slcohol, infertility, high fat diet, breast cancer, family hx, possibly related 2 the presence of ovarian cysts ( may be @ higher risk for ovarian cancer).
Ovarian cancer	Freq metastasizes before dx in colon, stomach, diaphragm.
Dx test used to diagnose ovarian cancer	Bimanual exam, pelvic ultrasound, pelvic ct, ca-125 substance, lower gi, ivp, cxr, lapraroscopy, parcentesis w/ cytology.
Med tx for ovarian cancer	Reoccurrence common: follow up q 2 mths for 2yrs, radiation.
Surgical tx for ovarian cancer	Total abdominal hysterectomy wit bilateral sapinoophorecomy (removal of uterus ovaries, & fallopian tubes).
Rx for ovarian cancer	Chemotherapy analgesics (pca or bromptons syrup), laxatives, tranqulizers antiemetics.
Bromptons syrup	Contains syrup, cocaine, morphine, alcohol, flavoring, water.
Things 2 assess for w/ ovarian cancer1	Fatigue, diarrhea, constipation, pelvic pressure, frequency of urination, loss of appetite, nausea, wt loss, vaginal bleeding or spotting w/ intercourse.
Things 2 assess for w/ ovarian cancer2	Malaise, foul smelling vaginal discharge, pain in the lower back, health hx, reproductive hx, palpable mass, pap smear >11, abnormal biopsies.
Things 2 assess for w/ ovarian cancer3	Abnormal appearance, increased abdonminal girth, ascites, pleural effusion.
What are the 5 menstruation disorders	Dysmenorrheal, amenorrhea, other(menorrhagia, metorrhagia, polymenorrhea), pms, comps of menopause.
Dysmenorrhea	Painful menstruation(cramps)
Causes of dysmenorrhea	Increased endocrine secretions, anatomical abnormalities, chronic illness, psych probs.
Pf’s of dysmenorrhea	Nulliparous, no intercourse.
Dx test for dysmenorrhea	Complaints, Pelvic exam,bimanual exam, ultrasound.
Prevention of dysmenorrheal	Positive attitude toward menstruation.
S/S of dysmenorrhea	Pelvic pain that can radiate before or at the onset of menstrual period caused by uterine spasms, narrowingof the cervical canal, emotional factors, Pid, Iud, endometriosis.
Rx used for dysmenorrhea	Analgesics, prostaglandin inhibitors(helps control of pain), oral contraceptives.
What is amenorrhea	Absence of menstruation.
What are the 2 types of amenorrhea	Primary & secondary
Primary amenorrhea	No menses by 17 y/o causes- anatomical or genetic abnormalities
Secondary amenorrhea	6 mths of normal menses & then stops or 12 mths of abnormal menses, then it stops.
Causes of secondary amenorrhea	Anorexia nervosa, excessive exercise w/ decrease in body fat, endocrine dysfunction, emotional disturbances, s/e of meds, pregnancy, lactation, hormone imbalance, nutritional deficits, pituitary tumors.
Dx test done for amenorrhea	Physical exam, pelvic exam, progesterone challenge test, serum prolactin.
Menorrhagia	excessively heavy flow.
Metorrhagia	Bleeding between periods.
Polymenorrhea	Short cycles(<21 days).
Oligomenorrhea	Decreased menstrual flow.
Causes of Pom2(aka other menstrual d/o)	low dose bcp’s, metabolic d/o, hormonal d/o.
Tx of Pom2 d/o	D & C, hysterectomy, blood transfusions, iron supplements.
Things to assess for in Pom2 d/o	describe bleeding (onset, timing, number of pads, pain, clots), hx of meds, contraception, pregnancy, stressors, health probs, v/s & labs.
Premenstrual syndrome(pms)	Group of s/s experienced during the secretory phase of the menstrual cycle.
Pf’s of Pms	Stress, poor nutrion, rx or s/e from bcp, sedentary lifestyle, marital status, hx of preeclampsia, muliparity, and hormone imbalance.
Dx test of Pms	Physical exam, keep calendar of s/s, labs to assess levels of: estrogen, progesterone, glucose.
S/S of Pms	Has over 150 s/s, Onset 7-10 days before menses & ends w/ start of flow, wt gain, bloating, irritability, edema, ha, edema, mood swings, inability to concentrate, food cravings, acne.
Rx for Pms	Tylenol, ibuprofen, naproxen, mifenamic acid, progesterone suppositories, last resort tranquilizers, antidepressants.
Diet for Pms1	Decrease: caffeine, dairy, chocolate, acidic foods, increase whole grains, nuts, pasta, herbal tea, legumes, root veggies, seafood, fruit.
Diet for Pms2	Vitamin supps w/ b complex vits, calcium, magnesium, zinc.
Activity for Pms	Reg exercise, stress management, imagery, meditation, positive affirmation, visualization, acupressure, yoga, massage: neurovascular, neurolymphatic.
Things to assess for in Pms	Wt, edema, labs, assess everything about all s/s.
Complications of menopause (climacteric) cessation of menstruation	Cessation of menstruation
Cause of menopause	Hormone decline
Pf’s menopause	45-60 y/o
S/S of menopause	gradually inc. over 1 yr relaxation of pelvic support structures decrease in skin elasticity & turgor, thinning hair, vaginal dryness, thinning of vaginal mucosa, wt gain, dry skin, hot flashes, stress incontinence, inc risk for fractures, depression, in
Rx for menopause	Estrogen replacement therapy: po, cream, or patch, keep ota for 10-15 secs before application given for 10-15 yrs after menopause, progesterone suppositories.
Diet for menopause	Increase calcium, magnesium, decrease fat, vit e, primrose oil, calcium supps.
Things to assess for in menopause	Hx of s/s, hx of menses, physical exam, pap smear.
Cystocele	Downward displacement of the bladder into the anterior vaginal wall.
Urethrocele	Downward displacement of the urethra into the vagina.
Rectocele	Anterior displacement of the rectum into the posterior vaginal wall.
Prolapsed uterus	Downward displacement of the uterus into the vagina.
Cause of CURP	Multipariety 3rd to 4th degree perineal lacerations from child birth, weaking of the pelvic muscles from aging.
Med tx for CURP	Decrease discomfort, restore structure & function.
Pessary	A small, molded, plastic or rubbery apparatus that fits into the vagina to provide support for the uterus.
Surgery for CURP	Prolapsed uterus
Colporrhapy	Surgical narrowing of the vagine done vaginally to put bladder, urethra, or rectum back in place.
MMK	Marshall, marchette, kranz, attaches the bladder to the inferior surface of the pubic bone.
Things 2 assess for with CURP	Stress incontinence, frequency, urgency, constipation, childbearing hx, onset of s/s, ua w/ exam can visualize bulging of the bladder, urethra, or rectum into the vagina.
Infertility	The inability to produce offspring.
Cause of infertility	Endocrine, anatomic, or immune systems d/o, decreased progesterone levels can cause spontaneous abortion, cause spontaneous abortion.
Infertility in couples	40% female, 40% male, combo 20%.
2 types of infertility	Primary-never been pregnant, secondary-inablity to conceive after having a child.
Dx test for infertility	Do full workup after having tried to conceive for 6-12 mths, basal body temp chart for 3 mths 1st half cycle-<98 degrees, 2nd half of cycle >98 degrees, endometrial biopsy, laparoscopy, endocrine imbalance tests, artificial insemination.
Artificial insemination	Place semen into the cervix or uterus w/ a small flexible catheter & syringe.
In vitro fertilization1	Gamete intra fallopian transfer- ovum & semen mixed in a catheter is injected into the fallopian tube.
In vitro fertilization2	Zygote Intra fallopian transfer or ivf-er (embryo transfer) several ova are mixed with sperm in a special fluid, wait 2-3 days, transfer fertilized ova into the fallopian tube.
Rx for infertility	Fix hormone levels, hcg, progesterone suppositories, testosterone, thyroid extracts.
Contraception	Prevention of pregnancy.
Contraception consist of	Natural method, barriers, spermicides, Iud, hormonal methods, bcp.
Natural method	Abstinence, rhythm method-no intercourse form 3 days before until 3 days after ovulation.
Barriers	Block the path of sperm, diaphragm, cervical cap, male & female condoms.
Spermicides	Kill sperm, work best in combination w/ barriers, do not use w/ apply @ least 15 mins before intercourse.
Intrauterine device (Iud)	Device irriates the uterine cavity (dalcon shield), in place for 1-7yrs s/e, bleeding & infection.
Hormonal methods	Oral contraceptives (bcp’s) suppress ovulation, make the body think that it is pregnant, 1:200 chance of pregnancy .
Bcp’s contraindicated if	No established menstrual, cycle, htn, dm, cvd, thrombophlebitis.
S/E of bcp	Ha, breast tenderness, nausea, wt gain, cva, thrombophlebitis.
Norplant	Levonorgestrel 6 pellets inserted under the skin in the arm, works for 5 yrs.
Depro Provera	Medroxyprofesterone acetate injection, IM q 12 wks suppresses ovulation, 3 weeks before effective s/e breakthrough bleeding.
Sterilization	Tubal ligation- laparoscopy to tie fallopiantubes, generalor epidural, 30-60 mins, vasectomy- surgical resection of the vas deferns.
Post op for vasectomy	Ice, rest, no strenuous activity, effective in 6 mths.
	Marshall, marchette, kranz, attaches the bladder to the inferior surface of the pubic bone.
Things 2 assess for with CURP	Stress incontinence, frequency, urgency, constipation, childbearing hx, onset of s/s, ua w/ exam can visualize bulging of the bladder, urethra, or rectum into the vagina.
Infertility	The inability to produce offspring.
Cause of infertility	Endocrine, anatomic, or immune systems d/o, decreased progesterone levels can cause spontaneous abortion, cause spontaneous abortion.
Infertility in couples	40% female, 40% male, combo 20%.
2 types of infertility	Primary-never been pregnant, secondary-inablity to conceive after having a child.
Dx test for infertility	Do full workup after having tried to conceive for 6-12 mths, basal body temp chart for 3 mths 1st half cycle-<98 degrees, 2nd half of cycle >98 degrees, endometrial biopsy, laparoscopy, endocrine imbalance tests, artificial insemination.
Artificial insemination	Place semen into the cervix or uterus w/ a small flexible catheter & syringe.
In vitro fertilization1	Gamete intra fallopian transfer- ovum & semen mixed in a catheter is injected into the fallopian tube.
In vitro fertilization2	Zygote Intra fallopian transfer or ivf-er (embryo transfer) several ova are mixed with sperm in a special fluid, wait 2-3 days, transfer fertilized ova into the fallopian tube.
Rx for infertility	Fix hormone levels, hcg, progesterone suppositories, testosterone, thyroid extracts.
Contraception	Prevention of pregnancy.
Contraception consist of	Natural method, barriers, spermicides, Iud, hormonal methods, bcp.
Natural method	Abstinence, rhythm method-no intercourse form 3 days before until 3 days after ovulation.
Barriers	Block the path of sperm, diaphragm, cervical cap, male & female condoms.
Spermicides	Kill sperm, work best in combination w/ barriers, do not use w/ apply @ least 15 mins before intercourse.
Intrauterine device (Iud)	Device irriates the uterine cavity (dalcon shield), in place for 1-7yrs s/e, bleeding & infection.
Hormonal methods	Oral contraceptives (bcp’s) suppress ovulation, make the body think that it is pregnant, 1:200 chance of pregnancy .
Bcp’s contraindicated if	No established menstrual, cycle, htn, dm, cvd, thrombophlebitis.
S/E of bcp	Ha, breast tenderness, nausea, wt gain, cva, thrombophlebitis.
Norplant	Levonorgestrel 6 pellets inserted under the skin in the arm, works for 5 yrs.
Depro Provera	Medroxyprofesterone acetate injection, IM q 12 wks suppresses ovulation, 3 weeks before effective s/e breakthrough bleeding.
Sterilization	Tubal ligation- laparoscopy to tie fallopiantubes, generalor epidural, 30-60 mins, vasectomy- surgical resection of the vas deferns.
Post op for vasectomy	Ice, rest, no strenuous activity, effective in 6 mths.

Created by: posiniv

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