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