Family planning Chapter 25 Elsevier

When counseling teenagers about contraception, it is important to teach them methods that do not require a clinic visit. Which one(s) of the following methods do not require a clinic appointment or prescription? (Select all that apply.)

ANS: -condoms -spermicides

A pregnant woman has requested a tubal ligation for contraception. The nurse is aware that this surgery can occur (Select all that apply.)

ANS: -during the postpartum period prior to being discharged from the hospital. -6 weeks postpartum -6 months postpartum

A woman is being counseled concerning the calendar method type of natural family planning. The woman states that her cycles run from 27 to 29 days. The nurse teaches the woman that ovulation will probably occur on about days

ANS: 13-15 -Ovulation occurs approximately 14 days before the onset of menses.

The nurse determines that teaching about contraceptives is effective when the patient makes which statement?

ANS: Condoms have very few side effects.

A woman who is 6 weeks postpartum and lactating is being counseled about contraception. She states that she desires to have a type of birth control that she does not have to "think about." She has three children, so it should be effective and she is in a monogamous relationship. She has a history of blood clots. One appropriate choice of birth control that the nurse can recommend is

ANS: IUD -Once they are inserted, IUDs provide long-term, continuous contraception without the need to take pills, have injections, or do something else before or during intercourse. They are appropriate for many women who cannot use hormonal contraception because of other problems, such as a history of blood clots. They are safe for use during lactation. Tubal ligation should be considered a permanent procedure; the woman did not request that type of contraception.

Nurses working with adolescent women should include questions regarding sexuality when gathering data for a reproductive health history. Which one(s) of the following principles should guide the nurse when interviewing the adolescent?

ANS: Misconceptions and inaccurate information expressed by the adolescent should be corrected promptly

A woman taking an oral contraceptive as her birth control method of choice should notify her health care provider immediately if she notes which one(s) of the following?

ANS: Swelling and pain in one of her legs (leg pain and swelling (edema) may indicate thrombophlebitis and should be reported immediately.)

A woman is requesting information concerning contraception. She is sexually active with multiple partners and is concerned about sexually transmitted diseases. When doing patient teaching, the nurse should be aware that the contraceptive method that offers the most protection against sexually transmitted diseases is

ANS: a male condom

A woman comes to the clinic stating that she is going on a hiking trip that will last 2 months. She states, "I have heard there are things that can be done to prevent me from having a period during that time." The nurse's response should be based on the knowledge that

ANS: certain oral contraceptive pills may be taken consecutively for 2 months to delay menses. (When women prefer extended cycles, in which menses is delayed for a few days for special occasions or for a longer time, they take two or more oral contraceptive pill packs without taking the placebo pills for several packs or indefinitely.)

A woman asks the nurse about the "new vaginal ring everyone is talking about for birth control." When counseling the woman about this method of contraception, the nurse should assess for the woman's

ANS: comfort level about self-insertion of the ring every 3 weeks

A woman has just been diagnosed as being 2 months pregnant. She is upset and states, "This is not possible, my husband had a vasectomy 3 months ago, and he should be sterile." The nurse should respond to this woman with the knowledge that a vasectomy

ANS: does not render a man sterile for about 3 months -Following a vasectomy, complete sterilization does not occur until sperm are no longer present in the semen. This may be 3 months or longer.

A woman is being admitted to the outpatient surgical unit for a tubal sterilization. She states to the nurse, "I know I have to go through with the surgery since I have already signed all the papers, but I was thinking this morning how wonderful it would be to have another baby." The nurse's next action should be to

ANS: inform the surgeon of the woman's feelings

During a breast exam, the midwife notes that the woman has a transdermal contraceptive patch applied to her breast. The midwife should

ANS: inform the woman that the patch should not be applied to the breast.

A woman calls the clinic early on a Monday morning stating that she needs a prescription for emergency contraception. On questioning by the nurse, the woman states that her boyfriend's condom was displaced during intercourse on Saturday night. The nurse should make an appointment for the woman

ANS: on Monday -The effectiveness of emergency contraception is greatest if used within 120 hours/5 days of unprotected intercourse

A lactating woman asks the nurse about contraception. She states that she has always used a combination pill and would like to continue with that method. The nurse should advise the woman that

ANS: progestin-only contraceptives may be started 4 weeks after birth -Combination oral contraceptives reduce milk production in lactating women, and very small amounts may be transferred to the milk. Progestin-only contraceptives may be a better choice if a woman wishes to use a hormonal contraceptive because they do not affect milk production. They are often started 4 to 6 weeks after birth.

A woman is to have an Essure procedure performed to produce sterilization. The nurse should include in the patient teaching that

ANS: the woman should use another form of birth control for 3 months after the procedure.

To increase the effective rate of male condoms, the female partner may

ANS: use a spermicide -Using spermicides with condoms increases lubrication, which decreases the risk of condom breakage. Effectiveness is increased when spermicides are used with condoms.

A woman called the clinic desiring to start on medroxyprogesterone acetate (Depo-Provera) for contraception. The nurse should make an appointment for the woman

ANS: within 7 days of the beginning of a menstrual period

A 26-year-old woman is considering medroxyprogesterone acetate (Depo-Provera) as the form of contraception that is best for her. To assist this woman with making a decision concerning this method of contraception, the nurse would tell her that Depo-Provera

ANS: would require that she return to the clinic every 3 months