Case Study: Sabrina Jackson - Practice and Learn: Teaching Birth Control

The nurse at the gyno office mentions some forms of contraception that require the woman to place her fingers in the vagina and insert and remove the contraceptive device. Sabrina does not think she wants to put her fingers in her vagina to insert or remove something. Based on her response, which contraceptive devices would Sabrina consider inappropriate.

Combined oral contraceptives

IUD

Diaphragm

Cervical Cap

Implants

Diaphragm and Cervical Cap

Sabrina admits that she does not have a regular routine and tends to forget things. based on this info, which form of contraception may be best?

Implants

IUD

mini progestin-only pills

contraceptive patch

diaphragm

Implants and IUD

Sabrina decides to get the Depo-Provera injection. the nurse knows that Sabrina understands how the shot works when she makes which of the following statements?

1. "the progestin prevents ovulation and thickens the cervical mucus to prevent preggo"

2. "the estrogen prevents ovulation and makes the uterine lining less hospitable to sperm "

3. "the hormones slow the motility of the sperm, and they cannot penetrate the eggs"

4."the progesterone prevents the normal estrogen surge and stops the pi

the progestin prevents ovulation and thickens the cervical mucus to prevent preggo

During the assessment, the nurse leanrs that sabrina has a regular 28-day cycle. her next period is expected to start in 8 days. She is getting her first shot today, what teaching will the nurse give?

you need to inform your partner that you got the shot

you may need to use vaginal lube

you may experience decreased arousal

you need a second form of BC

you may need a second form of birth control

the nurse explains that most of the AE w/ Depo-Provera decreases after the first year. what are common AE?

Weight gain

decreased interest in sex

increased cramps

infertility

heavy period

loss of bone mineral density

weight gain. decreased interest in sex, loss of bone density

what teaching does the nurse provide sabrina about choosing the shot?

during sex, use a condom to prevent STDs

you need to get a shot ever y12 weeks

if you miss a shot, you should use another form of BC until you get the shot

you will need to use water-soluble lube during sex

your cervical mucus will become watery and translucent in color

condom, every 12 weeks, miss a shot another form of BC

what are common reasons for condom failure that result in preggo?

unrolling the condom before putting it on the penis.

leaving space at tip of condom.

using an oil-based lube.

unrolling the condom with the rim outside.

leaving condom on after ejaculation.

unrolling the condom before putting it on, oil-based lube, leaving condom on after ejaculation

Sabrina goes to the student health center... it has been 10 days past her scheduled shot. She had unprotected sex. appropriate nursing action.

Admin shot to patient immediately.

offer patient emergency contraception.

ask why she did not use a condom.

explore alternative contraceptive devices w/ patient.

offer patient emergency contraception

sabrina wants to know more about emergency contraception. what forms of tx can be used?

having a copper IUD.

taking morning after pill.

scheduling D&C.

performing vaginal douche daily for a week.

injecting saline solution into uterus.

having copper IUD inserted and morning after pill

sabrina thinks she wants the emergency tx, but would like to talk about it with her SO. what time frame is she able to take it?

must be initiated within 3-5 days of unprotected sexual intercourse

the nurse teaches sabrina how to use a diaphragm

1. inspect the diaphragm for holes or tears

2. place spermicide around rim and in the dome

3. seperate the labia

4. pinch the rim of the diaphragm between the fingers and thumb.

5. insert into vagina

6. tuck the rim of the diaphragm behind the pubic bone.

7. leave in place for at least 6 hours after sex

the nurse instructs the pt that if the diaphragm is inserted more than 2 hours before having sex, what action is needed?

1. apply more spermicide in the vaginal prior to sex

2. recheck the position prior to sex.

3. ask partner to use a condom.

4. use an oil-based lube.

1. apply more spermicide in the vagina

when the diagram is removed after sex, what actions are taken for proper care?

Appropriate: wash with soap and water, air dry, store in cool, dry location

Bad care: store in warm & humid location, apply powder, wash with antiseptic solution

sabrina tells the nurse she will use breastfeeding as her method of contraception for the next year. the nurse explains....will only be effective if which of the following conditions are met?

1. baby exclusively BF

2. no more than 4 hours between feed

3. mom menstrual period not yet returned

4. mom is less than 6 mos post-delivery

5. baby takes bottle only w/ breastmilk

1 2 3 4

Safe to use while breastfeeding contraceptives

copper IUD

cervical cap

mini pills

depo-provera injeciton

diaphragm

progestin IUD

contraceptive methods to avoid while breastfeeding

vaginal ring

transdermal patch

combo oral contraceptive pills

Sabrina decides to use the mini pills. what is important info for her to know.

1. must be taken same time each day

2. can be taken up to 3 days after intercourse to avoid preggo

3. primary action is thickening of cervical mucus

4. primary action is to make sperm inactive as they enter uterus

5. pill is safe & effective during preggo

taken at same time each day,

primary action is thickening of cervical mucus, the pill is safe and effective during BF