Contraception & STIs Study Set | Exam 2 Terms & Definitions

makes cervical mucus thick

progesterone

makes cervical mucus thin

estrogen

basal body temperature method

take temp every morning before you get up (spike in temp= ovulation

no unprotected intercourse for 3 days after spike in temp

window of fertility

day 8-19 of period

lactation amenorrhea

baby less that 6 months

have to breast feed like 4-6 times a day for it to work

cervical mucus ovulation method

o Older clients

▪ Monitor mucus, abstain during egg white days

▪ Clear Phase is the best time to abstain from sex (WILL GET PREGNANT)

•Must be fitted by provider

•Refitted after pregnancy, abdominal or pelvic surgery, weight loss or gain of 10 lbs or greater

diaphragm

•Used with spermicide

•Inserted up to 2 hours before intercourses and leave in at least 6 hours after

diaphragm

Works bc it uses spermicide -> leave in at least 6 hours post intercourse to make sure spermicide can work

Can put in 2 hours before intercourse, void before putting in

Replace and refit every 1-2 years

diaphragm

•Smaller than a diaphragm, only covers the cervix

•Must be fitted by provider: 3 sizes

•Held in place by suction-do not place spermicide on rim

cervical cap

•Inserted up to 36 hours before intercourses and leave in for at least 6 hours, no longer than 48 hours

•Risk for toxic shock syndrome: avoid use during menstruation and 6 weeks after delivery

cervical cap

Uses suction to go over opening of cervix

Uses less spermicide, only has 3 sizes

Leave in atleast 6 hours -> risk for TTT during menstruation and 6 weeks post delivery

Refit if concerns with abdominal surgery, pregnancy, weight loss

cervical cap

•Soft concave device

•Contains spermicide

•Multiple uses within 24 hours

•Does not have to be fitted

cervical sponge

•Inserted up to 24 hours before intercourses and leave in for at least 6 hours

cervical sponge

Put in wet water and it blows up and activates spermicide

Is over the counter and can only use multiple times in 24 hours before disposing

Leave in at least 6 hour post intercourse

Can leave in multiple times over 24 hours

cervical sponge

2 hormones used to prevent pregnancy in the pill

estrogen

progesterone

would be given to breastfeeding mothers because estrogen decreases risk of milk supply

progesterone only pills

have to take at exact same time every day

Irregular bleeding/ spotting is number one side effect

progesterone only birth control

progesterone and estrogen -> doesn't have to be taken at exact time just around same time every day

combined contraception

prevents mature follicles for eggs to be released for fertilization -> makes cervical mucus thick and lining of mucus thin

birth control

3 ways to prevent pregnancy

low doses of hormones

cervical mucus thick

lining mucus thin

DVT, HTN, stroke, depression, and HA

S&S of estrogen containing birth control

older people need ______ BC

progesterone

ACHES acronyms for SE of birth control

abdominal pain

chest pain -> SOB

headaches -> increase BP or CVA

eye problems -> increase BP

severe leg pain -> DVT

▪ ↑ cervical mucus thickness (progesterone), Inhibits ovulation (estrogen), thins lining of uterus (progesterone) //// decrease sperm motility and transport

▪ Not good for smokers bc of risk for stroke or clot!!

combined birth control

▪ Thickens cervical mucus, thins uterine lining, must be taken at same time every day, safe for breastfeeding.

progesterone only birth control

good option of birth control if history of blood clots and smoking

progesterone only birth control

can cause breast milk to dry up

estrogen

what happens if you miss one pill

take as soon as remember and take other pill as scheduled

what happens if you miss 2 pills on week 1 or 2

take 2 pills a day for 2 days and finish package like normal

use backup method for sex for 7 days

what happens if you miss 2 pills on week 3

throw away pack and start new pack

use backup method for 7 days

what happens if you miss 3 or more pil,s

throw away pack and start new pack

use back up method for 7 days

if you have unprotected intercourse and have missed 2 or more pills, make sure to use

emergency contraceptive

Place on the lower abdomen, upper outer arm, buttocks or upper torso (expect breast)

Replace patch each week for 3 weeks then have a patch-free week

transdermal patch

•Change site when patch is reapplied

•198 lbs or less

tansdermal patch

Not the best for sensitive skin, an athlete who sweats, a swimmer

High dose of progesterone thru transdermal absorption

transdermal patch

•Inserted for 3 weeks then removed for a ring-free week

vaginal ring

stays in 3 weeks take out week 4 for withdrawal bleed

lower dose of estrogen and progesterone so decrease SE

can come out for up to 3 hours and is still effective

vaginal ring

•Given during the first 5 days of the menstrual cycle

•Injection received every 3 months

injectable progesterone (Depo-Provera)

•Flexible rod inserted by provider under the skin in upper arm

•Effective for 3 years

implants (Nexplanon)

Given during first 5 days of menstrual cycle, injection every 3 months

SE: irregular bleeding, weight gain, increases risk for osteoporosis, can decrease ovulation -> take 9 months for ovulation to occur again

injectable progesterone (Depo)

▪ Can cause significant bleeding, most common reason to discontinue, breakthrough bleeding

implantable progesterone (nexplanon)

hormone IUC

mirena

non hormonal IUC

paraguard

copper IUC

last 10 years

can be used for emergency contraception -> not common

non hromonal IUC (paraguard)

•Irritates the lining of the uterus, thins the endometrium and thickens cervical mucus

nonhormonal IUC

can cause an increase risk for ectopic pregnancy

IUC

Having multiple sex partner and not using protection can lead to ______________ with IUD (ghonorrhea and chlamydia)

pelvic inflammatory disease

provides a low amount of estrogen and progesterone daily

IUC

PAINS acronym for signs of complication with IUD

period late, pregnancy, abnormal spotting or bleeding

abdominal pain, pain with intercourse

infection exposure, abnormal vaginal discharge

not feeling well, fever, chills

string length shorter/longer/missing

•Use within 72 hours of unprotected intercourse

•No prescription or age restrictions

•DOES NOT induce abortion

•SE: nausea/vomiting, can delay menses

emergency contraception

very high dose of estrogen and progesterone

can make you nauseas

emergency contraception

▪ Thickens cervical mucus to prevent sperm from going in (thins lining of uterus)

▪ S.E: nausea and vomiting & cramps, delayed menses (no period for 3 weeks check for pregnancy)

emergency contraceptive

•Cutting the vas deferens

•Procedure is short and performed under local anesthesia

•Sexual function not impaired

vasectomy

Must use other contraception for 8-16 weeks bc sperm is still in semen, have to go back for 2 follow up visits

vasectomy

Provide sample and measure sperm in it and until zero, not totally effective

vasectomy

•Cutting/blocking the fallopian tubes

•Completed immediately after childbirth or by laparoscopic procedure

•Risk for ectopic pregnancy

•Sexual function unaffected

bilateral tubal ligation

taking out fallopian tube can decrease risk for

ovarian cancer

major risk with bilateral tubal ligation

ectopic pregnancy

•Can lead to infertility, pelvic inflammatory disease (PID), ectopic pregnancy, liver disease, cervical cancer, chronic pelvic pain, and death.

STIs

•Most common bacterial STI

•Curable with antibiotics

•If untreated can result in PID which may cause infertility

chlamydia

•Often asymptomatic

•Diagnosed by urine test or specimen swab collected from vagina

•Newborns can develop conjunctivitis during a vaginal delivery

chlamydia

Young age is most affected 16-19

Most pt come in believing they have a UTI

Diagnostic test: urinalysis (NAAT)

Men swab ureter women swab cervix

chlamydia

treatment for chlamydia

doxycycline 100mg 2 time PO 7 days

azithromycin 1g single dose

▪Transmitted through vaginal, anal, and oral sex

▪Can be passed to newborn during delivery: can cause conjunctivitis

▪Treatment- Doxycycline, Azythromycin for 7 days

▪No sexual activity for 7 days

▪Do not use Doxycycline during pregnancy

chlamydia

Teaching -> infertility, PID, conjunctivitis in baby, use condom, no sexual activity for 7 days

chlamydia

▪ Symptoms-

▪ Whitish yellow discharge

▪ Abnormal bleeding

▪ Painful urination (often come in thinking they have a UTI)

chlamydia

•2nd most common reported infection

•Curable with antibiotic

•Increases risk for: PID, infertility, ectopic pregnancy, and HIV

•Often asymptomatic

gonorrhoeae

•Pregnancy concerns: chorioamnionitis, PTL, PROM and postpartum endometritis

•Newborns can develop ophthalmia neonatorum

gonorrhoeae

▪ Often coinfected with Chlamydia

▪ Transmitted through vaginal, oral, and anal sex

▪ Can be passed to newborn during delivery

▪ Can cause blindness (ophthalmia neonatorum)

gonorrhoeae

Risk factors: unprotected sex, IUD, multiple partners

S&S: yellow/green discharge, dysuria, PID, very asymptomatic

gonorrhoeae

abdominal tenderness, cervical motion tenderness, fever (pt jumps off exam table if try to examine/touch cervix)

pelvic inflammatory disease

Diagnostic test: urine sample, vaginal swab inside cervical opening to get best sample

gonorrhoeae

medications for gonorrhoeae

azithromycin 1g PO

ceftriaxone (Rocephin) 250mg IM

doxycycline 100mg BID 10 days

•Parasitic infection

•Curable with antibiotics

•Can be asymptomatic or symptomatic (vulvar itching, frothy yellow/green vaginal discharge, dyspareunia, foul vaginal odor)

•Diagnosed by wet mount with microscope

trichomonas

S&S: itching, foul odor, yellow green frothy vaginal discharge, strawberry cervix (petechiae) -> parasites eating cervix, will occur with prolonged exposure

trichomonas

Diagnosis of trichomoniasis

wet mount

medication for trichomonas

2g of metronidazole (flagyl)

can make nauseas but one dose so give crackers

metronidazole

priority while on metronidazole

no alcohol

•Most common viral infection

•Cause of cervical cancer and genital warts

More than 40 types of

HPV

sex, skin to skin genital contact, young age, immunocompromised, unvaccinated (get age of 9, no cervical cancer)

HPV

S&S: cervical, anal, throat cancer, most is asymptomatic, genital warts

HOV

cure for HPV

HPV vaccine (Gardasil 9)

low risk HPV types cause

genital warts

high risk HPV types cause

cervical cancer

Associated with low risk HPV

Occurs on the cervix, vagina, urethra, anus, mouth, perineum, scrotum and perianal skin

condylomata

Can be painful, friable, pruritic or asymptomatic

Small, soft, fleshy papules

Large lesions can look like cauliflower

Warts can be removed but tend to return

can have a vaginal delivery with warts

condylomata

•Lifelong viral infection

•Transmission: contact of mucus membranes or breaks in skin with lesions visible or nonvisible

•Many are unaware they have HSV

•No cure: antivirals used for suppression

•Can be spread to newborn during a vaginal delivery

•Diagnosed by culture of fluid from vesicle

HSV

skin to skin contact w infected lesion, secretions, mucus membranes, can be spread to newborn during delivery -> c section to protect baby, can transmit even without active outbreak (always use condoms)

HSV

S&S: pain, itching, small sores, ulcers, scabs, can go dormant and reoccur

Period, intercourse, sugery and stress can cause flair up

Diagnose: blood test, test lesions, viral culture

HSV

medication for HSV

Acyclovir

do not scratch, wash hands, can spread skin to skin contact, watch for active lesions

HSV

more severe

last 2-3 weeks, swollen lymph nodes, multiple lesions, fever, dysuria

primary HSV lesions

milder

5-7 days, not as many outbreaks, itching/tingling/pain before outburst (fever blister)

recurrent HSV lesions

•Transmission: blood, salvia, semen, and vaginal secretions

•Risk: multiple sexual partners, unprotected receptive anal intercourses, history of other STIs

hepatitis B

Risk factors: unprotected sex, drug use (needles), healthcare workers

S&S: abdominal pain, clay stool, dark urine, jaundice, N/V, loss of appetite (attack on liver)

hep B

diagnostic test for Hep B

blood test to surface antibodies

Causes serious, permanent liver damage

Diagnosed by blood test to detect hepatitis B surface antibodies

Prevention through immunization

Hep B

give immunoglobulin 12 hours after birth

give vaccine after birth

do screenings

prevent the spread of transmission

interventions for Hep B