Family Planning: Oral Contraceptives

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Questions and Answers

Which statement accurately describes the types of oral contraceptives?

Combined oral contraceptives are exclusively monophasic with constant progestin levels.

Progestin-only contraceptives do not affect estrogen levels at all.

All oral contraceptives are contraindicated for women with high blood pressure.

Combined oral contraceptives can be triphasic with varying doses of hormones. (correct)

What is a notable side effect associated with oral contraceptive use?

Increase in muscle mass

Decrease in acne

Enhanced libido

Weight increase (correct)

What is the primary advantage of modern contraceptive methods like the NuvaRing?

They are more effective than oral contraceptives.

They eliminate the need for daily pill intake. (correct)

They prevent all forms of reproductive health issues.

They can alleviate the need for hormone-related medications.

Which condition is a contraindication for using DepoProvera®?

Deep vein thrombosis Signup and view all the answers

What common side effect might women experience with hormonal contraceptives that particularly affects physical appearance?

Increase in facial hair growth Signup and view all the answers

What is the mechanism by which emergency contraception such as Plan B and EllaOne work?

They inhibit ovulation and prevent fertilization. Signup and view all the answers

Which statement about IUDs is correct?

IUDs generally cause a local inflammatory response to prevent fertilization. Signup and view all the answers

Which of the following is a known side effect of taking emergency contraception?

Breast tenderness Signup and view all the answers

What is the recommended timing for the use of a diaphragm before intercourse?

No more than 2 hours prior to intercourse. Signup and view all the answers

What should individuals do if they do not menstruate within 3 weeks after using emergency contraception?

Perform a follow-up pregnancy test. Signup and view all the answers

What is the maximum duration that a cervical cap can be safely left in place?

48 hours Signup and view all the answers

Which of the following is a feature of the contraceptive sponge?

It has a central indentation to fit over the cervix. Signup and view all the answers

What is the reliability rate of the rhythm method in preventing pregnancy?

40% Signup and view all the answers

Which method is recommended for ensuring pregnancy checks after a vasectomy?

At 6 weeks, then 6 and 12 months later Signup and view all the answers

What are the possible complications of tubal ligation?

Infection, pain, and hemorrhage Signup and view all the answers

Which health issue is commonly experienced by mothers following delivery?

Bladder retention or inability to start urination Signup and view all the answers

What is the primary hemodynamic change that can indicate postpartal hemorrhage, particularly with a significant drop?

Drop in hematocrit of 10 points Signup and view all the answers

Which of the following is considered a common cause of early postpartal hemorrhage?

Uterine atony Signup and view all the answers

What condition may result in postpartum metritis due to retained products of conception?

Subinvolution of the placenta Signup and view all the answers

When assessing for postpartal hemorrhage, which vital sign change should be monitored most closely for its delay in appearance?

Increased pulse Signup and view all the answers

What is a key nursing action when observing for hemorrhage with steady lochia rubra?

Maintain IV access and administer fluids Signup and view all the answers

Which of the following conditions could potentially lead to uterine rupture during labor?

Multiple gestations Signup and view all the answers

In terms of infection, which symptom is least likely associated with metritis?

Severe abdominal pain Signup and view all the answers

A patient with inadequate uterine contractions post-delivery is at risk for which complication?

Uterine atony Signup and view all the answers

What is the most effective positioning technique for breastfeeding to alleviate a blocked milk duct?

Ensure the infant's chin points toward the blocked area. Signup and view all the answers

Which of the following symptoms is NOT typically associated with mastitis?

Painless swelling Signup and view all the answers

What is one effective way to decrease family stress when a neonate is admitted to the neonatal intensive care unit?

Allow families to stay close to the infant to promote bonding. Signup and view all the answers

What role do parents’ groups play in supporting siblings of neonates with abnormalities?

They offer emotional support and a network for the whole family. Signup and view all the answers

Which statement most accurately reflects a common response of older siblings when faced with a neonate containing abnormalities?

They may exhibit shame regarding the sibling's condition. Signup and view all the answers

What is a common bacterial source of mastitis in breastfeeding mothers?

Staphylococcus aureus Signup and view all the answers

Which symptom is NOT typically associated with mastitis?

Reduced milk production Signup and view all the answers

What is a recommended treatment for mastitis to prevent abscess formation?

Pumping or expressing milk from the affected side Signup and view all the answers

Which response best describes siblings' typical reactions to a neonate with abnormalities?

Younger children tend to show hostility, while older siblings may feel ashamed. Signup and view all the answers

What is a common indication of thrombophlebitis in the postpartal period?

Localized pain and swelling in the leg Signup and view all the answers

How can family stress be minimized when a neonate is admitted to the neonatal intensive care unit?

Provide facilities for families to stay close to the infant. Signup and view all the answers

Which of the following is NOT a typical symptom of a wound infection?

Rebound tenderness Signup and view all the answers

What is a crucial aspect of supporting siblings of a neonate with abnormalities?

Providing them with age-appropriate educational materials. Signup and view all the answers

What treatment measure is commonly recommended for the management of superficial thrombophlebitis?

Elevation of the affected limb Signup and view all the answers

What is a normal emotional response characterized in Kübler-Ross's Five Stages of Grief?

Acceptance Signup and view all the answers

Which scenario is most likely to contribute to the development of engorgement in breasts during breastfeeding?

Insufficient nursing leading to milk production outpacing demand Signup and view all the answers

What might indicate a blocked milk duct in a breastfeeding mother?

Hard, swollen area of tissue Signup and view all the answers

Which statement about the interaction of siblings with a neonate in critical care is true?

Siblings should be included in visitation and interaction whenever possible. Signup and view all the answers

What is an appropriate method to relieve breast engorgement?

Gently massage the breast during nursing Signup and view all the answers

What is an effective method for providing emotional support to families with a neonate requiring intensive care?

Providing contact information for peer support groups. Signup and view all the answers

Which symptom is NOT typically associated with urinary infection post childbirth?

Chills and high fever Signup and view all the answers

What is an incorrect approach for parents dealing with the stress of having a neonate in critical care?

Focusing anxiety on one sibling. Signup and view all the answers

What characteristic differentiates deep vein thrombophlebitis from superficial thrombophlebitis?

Deep vein thrombophlebitis poses a greater risk of clot migration Signup and view all the answers

When does the coagulation process generally return to normal postpartum?

Within 3 days Signup and view all the answers

Which treatment is NOT typically recommended for managing breast engorgement?

Using a breast pump frequently Signup and view all the answers

Study Notes

Family Planning: Contraception Methods

Oral Contraceptives

Two primary types: Combined (estrogen and progestin) and Progestin-only.
Combined contraceptives can be monophasic, biphasic, or triphasic.
Progestin-only pills generally have fewer side effects but can raise estrogen levels, increasing thrombosis risk.
Contraindications include smoking, history of breast cancer, coronary artery disease, and elevated cholesterol.
Common side effects include acne, weight gain, headaches, and breakthrough bleeding.

Injectable, Ring, and Patch Contraceptives

Newer methods include injectable (DepoProvera®), contraceptive ring (NuvaRing®), and patch (OrthoEvra®).
NuvaRing® is left in place for three weeks; effective as oral contraceptives.
OrthoEvra® patch is changed weekly for three weeks; patch-free in the fourth week, equally effective.
DepoProvera® is an injection given every 13 weeks, contraindicated in patients with a history of venous thromboembolism.

Emergency Contraception

Aimed at preventing pregnancy after unprotected intercourse; effective for up to 120 hours.
Options include Plan B (Levonorgestrel), Plan B One-Step, and EllaOne (Ulipristal acetate).
Follow-up pregnancy tests recommended if menstruation does not occur within three weeks; possible side effects include nausea and breast tenderness.

Contraceptive Devices

Condoms and IUDs

Male and female condoms are enhanced with spermicide but should avoid nonoxynol-9 due to possible STD protection interference.
IUDs are T-shaped devices with high efficacy (95-99%); can be left in place for years (e.g., ParaGard® up to 10 years).
ParaGard® is copper-based, while Mirena® releases levonorgestrel and is effective for five years.
IUD side effects include abnormal bleeding and risk of infection.

Diaphragm, Cervical Cap, and Sponge

Diaphragm is latex-based, requires fitting, and is 85-95% effective.
Cervical cap is smaller than the diaphragm, allows longer retention (up to 48 hours), and is also 85-95% effective.
Contraceptive sponge is impregnated with nonoxynol-9, effective for 85-95%, but does not protect against STDs.

Sterilization Procedures

Vasectomy: Male sterilization by severing the vas deferens; may have a 30-85% success rate if reversed.
Tubal Ligation: Female sterilization via blockage or severance of fallopian tubes, often during or after childbirth; reversal success rates vary (45-80%).

Maternal Complications Postpartum

Hemorrhage

Postpartum hemorrhage can be early (within 24 hours) or late (up to 6 weeks).
Normal blood loss: 500 mL for vaginal delivery, 1000 mL for cesarean.
Uterine atony and genital lacerations are common early causes.
Indicators of hemorrhage include increased pulse, decreased BP, and significant drops in hematocrit levels.

Infection

Metritis: Infection leading to endometrial inflammation, soothed with antibiotics; indicates included foul lochia and uterine tenderness.
Thrombophlebitis: Clots in vessel walls leading to inflammation and occlusion; treated with heat, anticoagulation, and activity limitation.

Breast Issues During Lactation

Engorgement

May occur within the first few days postpartum; can be relieved by frequent nursing and manual expression. Cold compresses offer pain relief.

Blocked Milk Duct

Generally opens within 24-48 hours; treated with heat, massage, and appropriate nursing positions to disperse milk blockage.

Mastitis

Infection signs include swelling, fever, and acute pain; treated with antibiotics and continued breastfeeding or pumping to prevent abscess formation.

Family Dynamics During Neonatal Complications

Inclusion of siblings in nurturing the neonate promotes bonding; stress may arise from the neonate's health issues affecting sibling interactions.
Educational resources and parental support groups help siblings cope with feelings of neglect or anxiety.
Steps to reduce family stress in NICU involve promoting family presence, encouraging breastfeeding, and facilitating parental interaction with the neonate.### Family Dynamics and Support
Parents may become hypercritical of one sibling due to stress, necessitating staff intervention and support from other family members.
Inclusion of children in educational demonstrations and the availability of age-appropriate resources helps siblings understand medical conditions.
Family-focused parents’ groups provide valuable support.

Decreasing Family Stress

Neonatal intensive care unit (NICU) admissions disrupt family bonding; measures are crucial to alleviate stress:
- Facilities for family members to stay near their neonate promote bonding.
- Play areas for siblings prevent feelings of isolation from parents.
- Encourage breastfeeding or pumping to strengthen maternal-child connection.
- Liberal visiting hours allow family presence.
- Advance visits to the NICU can prepare families for potential critical care needs.
- Provide contact information for support groups of other parents facing similar challenges.
- Promote hands-on parenting experiences like kangaroo care.

Kübler-Ross's Five Stages of Grief

Grief responses to infant loss or severe illness vary among individuals:
- Denial: Parents may resist accepting reality, showing confusion and disengagement.
- Anger: Initial acceptance leads to anger directed inward (self-blame) or outward.
- Bargaining: Parents engage in "if-then" thoughts, attempting to alter outcomes through promises or changes.
- Depression: As acceptance grows, parents may experience overwhelming sadness and withdrawal.
- Acceptance: Eventually, parents can reminisce about their infant without intense pain, recognizing the normalcy of loss.

Support for Parents/Family of Dying Neonate

Emotional support is vital at different stages surrounding the death of a neonate:
- Before Death: Offer quiet presence, avoid clichés, refrain from judgment, and provide supportive touch.
- At Time of Death: Reassure families about comfort care, share personal feelings of loss, and provide information about the dying process.
- After Death: Respect family needs, facilitate emotional expression, and provide information about support resources.

Types of Grief

Anticipatory Grief: Mourning potential loss occurs prior to death due to terminal illness diagnosis.
Delayed Grief: Feelings of loss surface long after the child’s death, often masking emotions due to social expectations.

Grief-Gender Differences

Women typically express grief more emotionally and seek social support.
Men often grieve in a solitary manner, focusing on problem-solving and factual information.

Factors Influencing Grief

Cultural Influences: Cultural beliefs shape grief responses and mourning rituals.
Family System Dynamics: Family composition and financial status affect the expression of grief.
Impact on Siblings: The emotional response of siblings must be addressed alongside parental grief.
History of Loss: Families with previous experiences of loss may grieve differently, especially with hereditary conditions.

Post-Cesarean Care

Cesarean mothers require both surgical recovery support and routine care:
- Deep breathing and coughing should be practiced with abdominal support.
- Mobilization is essential within 24 hours post-surgery.
- Pain management involves PCA, oral, and parenteral medications; breastfeeding positioning is crucial.

High-Risk Mother Care

Diabetes Mellitus:
- Monitoring blood sugar is essential post-delivery due to insulin requirement changes.
- Breastfeeding may decrease insulin needs.
Cardiac Disease:
- Close observation is necessary after birth; support is crucial to avoid complications.
- Education on potential health risks is vital for mothers and infants.
HIV/AIDS:
- Asymptomatic mothers usually face no additional risks during pregnancy, but careful monitoring is key.
- Elective C-section may be recommended to reduce neonatal transmission risk.

CDC Isolation Guidelines

Adherence to standard precautions is essential in managing infections and protecting vulnerable populations.

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Description

This quiz explores the various methods of oral contraceptives used in family planning, focusing on hormonal methods and their types. Learn about the different brands and their hormonal compositions, including combined and progestin-only options.