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Family planning
| Question | Answer |
|---|---|
| Family Planning | Any educational, social, or healthcare intervention that allows people to plan reproduction including contraception, abortion, and interventions for subfertility or infertility. |
| Contraception | Methods to prevent pregnancy, behavioral, barrier, hormonal, and permanent options. |
| Abortion care | Medical and surgical options; a legal aspect of reproductive health care in many states. |
| Infertility support | Evaluation and treatment for subfertility; education and emotional support for patients. |
| Nursing role in family planning | Be respectful of patient choices and avoid interjecting personal biases in family planning conversations. |
| Selecting a contraceptive method | reproductive goals reliability: effectiveness with perfect or typical use Safety profile: side effects, contradictions, patient history cost & convenience: accessibility, affordability method continuation: likelihood of consistency and correctly |
| What to do before selecting a contraceptive method? | Rule out pregnancy before starting any method! |
| Birth control methods | there are five types of birth control methods from which to choose according to one's health, relationship status, lifestyle, and reproductive plans. |
| sterilization method (most effective) | 99% effectiveness permanent tubal ligation male vasectomy |
| long acting methods | 99% effectiveness reversible IUD implants |
| short acting methods | 91-84% effectiveness reversible pills shots rings |
| barrier only methods | 86-71% effectiveness reversible condoms diaphragms sponges cervical caps |
| natural rhythm methods | 78-75% effectiveness natural family planning (menstruation) withdrawal |
| contraception method (behavioral methods) | abstinence fertility awareness - cervical mucus ovulation method - basal body temperature - symptothermal method - standard days method withdrawal (coitus interruptus) lactation amenorrhea method |
| cervical mucus ovulation method | thin and stretchy, ripe time for pregnancy |
| lactation amenorrhea method | A natural, temporary form of contraception that uses breastfeeding to suppress ovulation |
| contraception method (hormonal methods) | long-term but reversible protection against pregnancy oral contraceptives injectable-depo transdermal patch vaginal rings implantable-nexplanon (LARC) IUD Emergency |
| ACHES: warning signs for oral contraceptive users | teach patients to report any of these symptoms immediately, may indicate a serious complication |
| (A)CHES | abdominal pain may indicate liver problems, pancreatitis, or gallbladder disease |
| A(C)HES | chest pain/shortness of breath may indicate pulmonary embolus (PE) or myocardial infarction (MI) |
| AC(H)ES | headaches (severe) may indicate hypertension, migraines, impending stroke (CVA) |
| ACH(E)S | eye problems/vision changes may indicate hypertension or cerebrovascular accident (CVA) |
| ACHE(S) | severe leg pain may indicate deep vein thrombosis (DVT) or thromboembolic event |
| Intrauterine contraception | IUC/IUD T shaped plastic devices inserted into the uterus. Pregnancy rate <1%. two types: copper and progestin releasing |
| Copper IUD (paraguard) | Hormone-free inhibits sperm motility, capacitation & survival effective for 10-12 years (can be pulled immediately) can be used as emergency contraception within 5-7 days of unprotected sex may cause heavier periods and increased cramping |
| Progestin IUD (Mirena, Kyleena, Liletta) | Causes inhospitable changes to cervical mucus and endometrial atrophy variable effects on ovulation depending on type effective 3-8 years depending on the device often reduces menstrual bleeding over time |
| Important | there is no evidence that any IUD acts as an abortifacient or disrupts an existing pregnancy |
| contraception method (sterilization) | tubal ligation - a laparoscope is inserted; fallopian tubes are grasped and sealed vasectomy- performed under local anesthesia. involves cutting the vas deferens |
| Nursing management: contraceptive counseling assessment | medical history family history ob/gyn history personal & social history diagnostic testing as indicated! pregnancy test complete physical examination |
| Nursing management: contraceptive counseling nursing intervention | shared decision making: include client/couple in choice client education: MOA, advantages, disadvantages correct misconceptions danger signs: ACHES backup methods: educate if method fails |
| abortion care surgical abortion | vacuum aspiration (most common in first semester) dilation & evacuation (D&E) second trimester performed in clinic or hospital setting safe and effective with local complication rates |
| abortion care medical abortion | methotrexate+ misoprostol - less commonly used mifepristone + misoprostol - FDA approved up to 10 weeks can be managed via telehealth in some states follow-up required to confirm completion |
| nursing role abortion care | Provide non-judgemental, patient-centered. Abortion is legal aspect of reproductive health in many states. Nurses must provide education, emotional support, and inappropriate follow-up. |
| Emergency contraception | Plan b Levonorgesterel, Ella (Ulipristal acetate), Copper IUD |
| Plan B Levonorgesterel | Window: 72 hour or 3 days Access: OTC Mechanism: Delays or inhibits ovulation; not an abortifacient |
| Ella (Ulipristal acetate) | Window: within 120 hours or 5 days Access: prescription required Mechanism: modulates progesterone receptor; more effective later in window |
| Copper IUD | Window: within 5-7 days Access: inserted by provider Mechanism: most effective EC option; also provides ongoing contraception |
| Nursing management - Plan B | side effects: nausea, stomach ache, breast tenderness, diarrhea, fatigue, dizziness (last a few days) if vomiting occurs within 3 hours of taking: contact HCP - may need to repeat dose use barrier contraception for the remainder of cycle |
| Nursing management - Plan B | if period is 5+ days late after taking Plan B: take a pregnancy test and contact HCP |
| STIs: treating on a population scale | curable vs incurable safer sex practices the problem of STIs has still not been tackled adequately on a global scale, and until this is done, numbers worldwide will continue to increase. |
| STIs: Prevalence & Risk Factors | high risk groups: African American youths abused youths homeless youths young men who have sex with men LGBTQ+ youths |
| STIs: Prevalence & Risk Factors | risk factors in teenagers: columnar epithelial cells sensitive to invasion feelings of invincibility unprotected sex short-duration partnerships barriers to accessing healthcare |
| HIV: US & Global Impact. Key nursing action | Universal HIV screening in pregnancy + ART initiation is the most effective intervention to prevent perinatal transmission. |
| STIs: Key maternal & Neonatal Effects Chlamydia | Maternal Effects: postpartum endometritis, PROMm preterm birth Fetal / Neonatal Effects: Neonatal conjunctivitis leading to blindness , pneumonia, low birth weight |
| STIs: Key maternal & Neonatal Effects Gonorrhea | Maternal: Chorioamnionitis, PROM, fetal growth restriction postpartum sepsis Fetal / Neonatal Effects: Gonoccal opthalmia neonatorum leading to blindness, sepsis, meningitis |
| STIs: Key maternal & Neonatal Effects Syphillis | Maternal: Spontaneous abortion, preterm birth, stillbirth Fetal / Neonatal Effects: Congenital syphillis: multi-organ failure, structural damage |
| STIs: Key maternal & Neonatal Effects Genital Herpes | Maternal: Spontaneous abortion, PROM, preterm labor Fetal / Neonatal: Skin/mouth sores, mental disability, blindness, death |
| STIs: Key maternal & Neonatal Effects HIV | Maternal: Fatigue, nausea, weight loss, immunosuppression Fetal / Neonatal Effects: Transmission transplacentally, during birth, or via breast milk |
| STIs: Key maternal & Neonatal Effects Hepatitis B | Maternal: May cause preterm birth if active in last trimester Fetal / Neonatal Effects: Chronic carrier risk, liver cancer on cirrhosis |
| STIs: Key maternal & Neonatal Effects Trichomoniasis | Maternal: PROM, preterm birth risk Fetal / Neonatal Effects: Low birth weight, prematurity |
| STIs: Key maternal & Neonatal Effects Bacterial Vaginosis | Maternal: Spontaneous abortion, chrioamnioitis, preterm labor Fetal / Neonatal Effects: Neonatal sepsis |
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