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OB Chapter 20

Family Planning and Infertility

instructions for the use of a male condom on erection before touching vagina; No oil based lubricants; half inch space at tip; withdraw soon after ejaculation while still erect; hold condom in place at the same time of withdrawal; do not reuse
barrier methods should not be used with a woman with a history of? Toxic shock syndrome or frequent urinary tract infections
teaching plan for a female condom insert up to 8 hours before intercourse; OTC; should not be used with a male condom; one time use; typical failure rate is 21%; wash hands with soap and water before insertion
teaching for diaphragms must be fitted; needs to be rechecked for correct size after each term birth and if a woman gains or loses 10 lbs or more; allergy is only known side effect that may occur
who should not take oral contraceptives vascular pathologic condition; embolism; stroke; atherosclerosis; heart failure; hypertension; heart disease; breast cancer within 5 years; diabetes with neuropathy; retinopathy, liver disease; smoking; older than 35; pregnancy; migraines with aura
what to tell a woman who forgets to take her pill take as soon as remembered; if 2 or more at beginning of cycle, take 2 pills for the next 2 days and use backup method to end of cycle; no back up needed for missing blank pills, just throw away blank ones and continue; if 3 missed, start over
fertility awareness method the understanding that a woman is fertile at ovulation, which occurs approximately 14 days before the next menstrual period
informed consent before sterilization required by law before procedure; must be signed before any medication is given before surgery; in native language and level of understanding; should include risks, benefits, alternatives and statement that it may be permanent and irreversible
gamete intrafallopian transfer hormones given to stimulate ovulation, and ova are collected laparoscopically; at least one normal, patent fallopian tube needed; after 3 to 7 day abstinence, male sperm is collected, prepared and used to fertilize ova within the fallopian tube
clomiphene citrate and multiple births, addressing concern with woman more than one ovum may be released and fertilized, making twins and triplets more common; side effects include hot flashes and vision changes
calendar method of contraception AKA rhythm method; based on a calendar documentation of menstrual cycles and calculation of fertile period; intercourse is avoided during fertile period
what assumption is calendar method based on ovulation occurs approximately 14 days before the onset of the next menstrual period and the knowledge that the sperm is viable for 48 to 120 hours (5 days) and the ovum is viable for 24 hours
nonoxynol-9 lubricated condoms have been shown to protect against Neisseria gonorrhea, chlamydial infection, and HIV, but frequent use can cause genital lesions and actually increase risk for HIV infection
IUDs not recommended for women with multiple sex partners because they provide no protection against STIs
What is encouraged for couples with infertility support groups
sterilization and sexual functioning vasectomy and tubal ligation have no effect on sexual performance, nor on menstruation in women
smoking and fertility increases the peristalsis within the fallopian tubes, this may increase the risk of ectopic pregnancy; may play a role in impaired fertility
least effective methods of contraception calendar method
primary infertility the couple is unable to conceive at all after at least 1 year of unprotected sexual intercourse
secondary infertility after one successful pregnancy, the couple is unable to conceive a second time
number of ejaculations needed postvasectomy 36 ejaculations in approximately 6 weeks
teaching for depo-provera shots side effects: menstrual spotting, headache, and weight gain; need to take additional calcium and to exercise to minimize the risk of osteoporosis; do not massage the injection site; may last up to a year
Created by: laotracuata