Reproductive Life Planning and Nursing Process

Study Notes

Involves decisions about having children.
Contraceptive method selection should be informed, considering advantages, disadvantages, and side effects.
Factors to consider: personal values, method usage, sexual enjoyment impact, financial factors, relationship status, prior experiences, future plans.

Assessment: Inquire about reproductive life planning needs during health history.
Nursing Diagnoses:
- Readiness for enhanced knowledge regarding contraception options
- Deficient knowledge related to specific contraceptive methods
- Various diagnoses related to spiritual, decisional, and emotional concerns about contraception.
Planning and Implementation:
- Establish realistic care plans.
- Respect spiritual, cultural, and moral beliefs during counseling.
Outcome and Evaluation:
- Evaluate method effectiveness and satisfaction.
- Reassess early after starting a new method.
- Examples of expected outcomes: - Patient feels confident in their chosen method. - Patient expresses satisfaction with the method. - Patient consistently uses the chosen method without pregnancy.

Vital signs, Pap smear, pregnancy test, STI screening, and hemoglobin level.
Obstetric history, including STIs, pregnancies, abortions, previous method failures, and compliance.
Patient’s desires, needs, feelings, and understanding of conception.
Sexual practices, including frequency, number of partners, feelings, and body image.

Abstinence: Refraining from sexual relations, 0% theoretical failure rate, most effective STI prevention.
Lactation Amenorrhea: Natural ovulation suppression while breastfeeding, but not reliable, should not be used beyond 6 months of breastfeeding.
Coitus Interruptus (Withdrawal): Withdraws penis before ejaculation, ineffective due to pre-ejaculatory fluid.
Calendar/ Rhythm Method: Abstinence during fertile window (3-4 days before and after ovulation), requires meticulous tracking.
Basal Body Temperature Method: Tracks daily body temperature changes (rise after ovulation), requires consistent measurement.
Cervical Mucus (Billings) Method: Monitors cervical mucus changes associated with ovulation, requires daily assessment and understanding of mucus consistency.
Two-Day Method: Assesses daily for vaginal secretions, avoids intercourse for 2 days if secretions present.
Symptothermal Method: Combines cervical mucus method and basal body temperature.
Fertility Beads/ Cycle Beads: Color-coded beads track menstrual cycles, identify fertile and non-fertile days, and monitor cycle range.
Ovulation Awareness: Uses over-the-counter ovulation detection kits to detect luteinizing hormone surge in urine.

Barrier Methods:
- Spermicides: Chemicals that kill sperm, available in various forms (cream, gel, foam, film, suppositories).
- Male Condoms: Latex or synthetic sheath placed on penis during intercourse, prevents sperm deposition.
- Female Condoms: Latex or polyurethane sheath inserted into vagina, inner ring covers cervix, outer ring rests against the vaginal opening.
- Diaphragm: Circular rubber disc fitted over cervix before intercourse, left in place for 6 hours after intercourse.
Hormonal Contraception:
- Subcutaneous/ Subdermal Implants: Slowly releasing hormones, suppress ovulation, thicken cervical mucus, and change endometrium to prevent implantation.
- Intramuscular Injections: Medroxyprogesterone acetate (DMPA) given every 12 weeks.
- Estrogen/progestin combination: Commonly used hormonal contraception.
- Progestin impregnated rings or progestin patches: Hormonal options delivered through rings or patches.
Intrauterine Devices (IUDs): Small plastic device inserted into uterus, prevents pregnancy by interfering with sperm transport and fertilization.

Vasectomy: Surgical procedure on men, cuts and blocks the vas deferens, preventing sperm transport.
Tubal Ligation: Surgical procedure on women, occludes fallopian tubes, preventing sperm and egg meeting.

These methods can impact sexual enjoyment in different ways.
- Barriers can reduce sensation.
- Hormonal changes can alter libido.
- Surgical procedures can affect body image.