Maternity Exam #3: Contraception, Infertility and Abortion

The nurse is meeting with a young couple who have undergone the initial screenings for infertility. The man is questioning the possibility of using intrauterine (artificial) insemination if he is found to be infertile. Which response should the nurse prioritize?

"Intrauterine (artificial) insemination is your best option if you are found to be infertile."

A nurse is instructing a client on the use of home-use ovulation determination kits. What is most appropriate for the nurse to tell the client?

"The kit will help determine when your body is preparing for ovulation." "The home-use ovulation determination kit monitors LH or FSH hormone in a urine sample. In LH kits it monitors for a surge in the hormone that would indicate ovulation is getting ready to occur.

The nurse educates a 15-year-old female client on ways to prevent pregnancy. Which statement will the nurse include in the teaching?

"The use of a condom is a method often recommended to prevent pregnancy for people your age."

how long before emergency contraception does an anti-nausea med need to be taken to prevent interactions?

1 hour

how often should a diaphragm be replaced?

2 years

what is the maximum amount of time a contraceptive sponge be left in the vagina due to the risk of toxic shock?

30 hours

Which statement is false regarding emergency contraception (EC)?

EC will disrupt an established pregnancy if taken within 72 hours.; not an established one!

A nurse is visiting with a couple who has recently completed subfertility assessments and are awaiting the results. Throughout the conversation the wife intermittently begins to cry. What would be the most appropriate nursing diagnosis for this couple?

Fear related to possible outcome of subfertility studies

what vaginal secretions appear after ovulation?

It becomes thick and dry after ovulation, under the influence of progesterone.

A client asks the nurse if a cervical cap is better than a diaphragm for contraception. What should the nurse explain is the advantage of a cervical cap?

It can be left in place longer.

A client has been following the conventional 28-day regimen for contraception. She is now considering switching to an extended oral contraceptive pills (OCPs) regimen. She is seeking information about specific safety precautions. Which is true for the extended OCP regimen?

It carries the same safety profile as the 28-day regimen.

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which statement is appropriate for the nurse to include in the response?

"Cervical caps are most effective when used along with a spermicidal agent."

female condom

a barrier method of birth control that contains two semirigid rings attached to the opening of a nitrile tube that is placed in the vagina similarly to a tampon and offers some protection to the labia and base of the penis; higher protection against STI's; should be twisted upon removal to prevent spillage of semen

Female sterilization (bilateral tubal ligation)

a procedure that involves either cutting or mechanically blocking the fallopian tubes

essure

a stainless steel coil used in female sterilization to mechanically block the fallopian tubes

dilation and evacuation

a surgical abortion that can be obtained up to 20 weeks gestation

pregnancy symptoms

symptoms that are common with the combined oral contraceptive pill and include irregular bleeding, nausea, breast tenderness, spotty darkening of the skin, mild headaches, mood changes, depression, decreased sex drive, and dyspareunia

what should one do if they miss 1 pill of a progestin-only pill pack?

take 1 pill when remembered and use backup protection for the next 7 days

what should one do if they forget 2 pills in weeks 1 or 2 of a progestin-only pill pack?

take 2 pills when remembered and 2 pills the next day

what should one do if they miss 2 pills during week 3 or 3 pills in a row of a progestin pill pack?

take one pill daily until sunday then begin a new pack

Levonorgestrel

the component in IUDs; different types release at different speeds/rates

primary infertility

the couple has never achieved pregnancy

abortion

the expusion of the products of conception before the embryo or fetus is viable that is usually prior to the 20th week of gestation or the delivery of a fetus weighing less than 500 grams

semen analysis

the most important indicator of male fertility. The man should abstain from sexual activity for 2 to 5 days before giving the sample. For a semen examination, the man is asked to produce a specimen by ejaculating into a specimen container and delivering it to the laboratory for analysis within 1 hour. When the specimen is brought to the laboratory, it is analyzed for volume, viscosity, number of sperm, sperm viability, motility, and sperm shape.

A young woman says she needs a temporary contraceptive but has a latex allergy. She mentions that she has had a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend?

transdermal contraception The fact that this woman has a latex allergy rules out the cervical cap and diaphragm. Moreover, the diaphragm is contraindicated in her case due to her papillomavirus infection. The best choice for her is transdermal contraception, which involves wearing a patch for a week at a time and does not require taking pills daily.

true or false: In some states, a waiting period is required between counseling and an abortive procedure.

true

what are the nonhormonal methods of birth control?

tubal ligation, vasectomy, copper IUD, diaphragm, condom, spermicide, and rhythm method

anovulation

absence of ovulation

withdrawl method (coitus interruptus)

also known as the "pull out method" is the avoidance of ejaculation into the vagina during intercourse.

what are the contraindications of the DMPA injection?

aminoglutethimide or long term corticosteroid therapy, planning pregnancy in the next year

skyla

an IUD that is effective for 3 years

Liletta

an IUD that is effective for 3-7 years

kyleena

an IUD that is effective for 5 years double e = longer

medication abortion

an abortion that can be obtained up to 6-9 weeks after conception in which mifiprex/mifepristone is used to block progesterone resulting in the detachment of the embryo and misoprostol is used to expel the products of conception; side effects include cramping, bleeding, nausea, vomiting, and headache

what medications reduce the effectiveness of the combined oral contraceptive pill?

antibiotics, anti-seizure medications, rifampin, st. john's wort, and diflucan (fluconazole)

what are the risks for estrogen-progestin contraceptives?

arterial/venous thrombosis, HTN, stroke, cervical cancer if at high risk for HPV

when should the fit of a diaphragm be checked?

birth, miscarriage or abortion, and gaining or losing more than 10 lbs

Weight loss/gain

can contribute to aiding in oligoovulation or annovulation

what are the contraindications of progestin?

cancer and acute viral hepatitis

Misoprostol

causes uterine contractions to expel the uterine contents.

what are the symptoms of IUD?

change in bleeding patterns (periods may become lighter), potential pain on intercourse with the strings of the IUC poking the head of the penis

what special considerations should be kept in mind when using a contraceptive ring?

check the placement after a bowel movement, it can become dislodged and most women use a tampon applicator to put it in

what are the contraindications for use of a copper IUD?

copper allergy or rare wilson disease

what are the contraindications for the Nexplanon?

current breast cancer; efficacy may be diminished in women using antiretroviral meds

body temperature slightly _______ just prior to ovulation and then _________

decreases; spikes; temperature should be taken before activity in the morning so that nothing affects it

mechanical dilation

dilation used for first trimester abortions; used at the time of the procedure

what are the side effects of the diaphram?

discomfort during sex or frequent urinary tract infections, vaginal irritation and, very rarely, toxic shock syndrome.

large cervical cap

for women who have delivered a pregnancy vaginally.

Monophasic oral contraceptive

have the same hormone level in each of the 21 estrogen-progestin pills.

secondary infertility

inability to conceive after a previous pregnancy

hysterotomy

incision into the uterus done after 20 weeks for abortion

what are the risks with abortions?

infection, retained products of conception, trauma to uterus and cervix, and excessive bleeding

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about?

overstimulation of the ovary resulting in potential multiple births

A clinic nurse is interviewing a young client during a subfertility work up. When the client asks the nurse what causes infertility, the nurse informs the client that the problem can rest with the man, the woman, or both. What does the nurse tell the client are common problem areas related to the woman? Select all that apply.

ovulation tubal transport impaired implantation

aromatose inhibitors

particularly letrozole, are a common second-line choice after clomiphene citrate failure

A male is diagnosed as being infertile, but he wants to have children with his spouse. Which response should the nurse provide to this client?

"You need to consider donor-alternative insemination."

how does progestin prevent pregnancy?

1.) decreases the volume and increases the viscosity of cervical mucus which blocks sperm 2.) suppression of ovulation (less so than estrogen) 3.)thinning of uterine lining

how long is the copper IUD effective for?

10 years

within how long after unprotected sex does one need to take ulipristal (ella)?

120 hours

how often is the depoprovera shot given?

13 weeks/every three months; there is a 2 week wiggle period

how long can an ovum survivie?

24 hours

how long prior to sexual intercourse can the contraceptive sponge be placed?

24 hours

If EC is vomited within ______ hours of admin then a second dose should be taken but if it was greater then it will not affect the efficacy

3

after _____ months a women is consdiered sterile after BTL

3

When should the nurse instruct a female client using the basal body temperature method of contraception to refrain from having sexual intercourse?

3 days after recording a slight drop in temperature followed by an increase

when is it unsafe to have intercourse?

3 days before and 3 days after ovulation

how long can a contraceptive ring be left out of the vagina for?

3 hours per day

when are essure and adiana confirmed?

3 months

how long is the nexplanon implant approved for?

3 years; although hormones are released for four years

what BMI makes hormonal birth control methods less effective?

30

how long can sperm survivive?

5 days

how long is one's fertile window?

6 days

A community health nurse is preparing a presentation for a health fair on the topics of planning for a pregnancy. Which major goal has the nurse determined should be accomplished with this presentation?

Decrease the number of unwanted pregnancies. Preconception counseling with general health care is a health promotion activity to help prevent unwanted pregnancies. The nurse will be responsible for presenting the basic information to everyone. In this environment it would not be appropriate for the nurse to provide one-on-one counseling due to privacy concerns. The nurse could present various risks but it would be beyond the scope of this event to ensure every participant understands each point.

A young client comes to the clinic and requests birth control pills to prevent a pregnancy. She tells the nurse that she is worried that she will get mixed up on what days to take the pills. Which would be the best type of pills to prescribe this client?

Oral contraceptive pills packaged with 28 pills Oral contraceptive pills (OCPs) are packaged with 21 or 28 pills. To eliminate having to count days between pill cycles, most brands are packaged with 28 pills: 21 active pills and 7 placebo pills. There is no need to skip days because the menstrual flow will begin during the 7 days on which she takes the placebo tablets.

how long should birth control be used after a vasectomy?

The client should use birth control measures until his sperm count remains at zero for 6 weeks.

The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurse's best response?

The couple can control the time between births when they plan their family.

A client with liver disease is seen in the clinic wanting to begin contraception. The nurse recognizes that which type of contraception is best for this client?

Vaginal estrogen/progestin (contraceptive) ring The nurse should recognize that the vaginal estrogen/progestin ring releases hormones into the mucous membranes of the vagina and avoids the "first pass" through the liver.

natural family planning (NFP)/fertility awareness method (rhythm method)

a method of birth control that relies on the predictability of the female reproductive cycle and timing of intercourse in which the couple avoids intercourse on days 8-19 of the menstrual cycle since those are considered the "fertile days"

mirena

a progestin IUD that is effective for 5-7 years double e = longer

closed adoption

an adoption in which no identifying data about the birth family or adoptive family is shared and there is no contact between the families; records will not be available to the child until they reach 18

open adoption

an adoption in which there is some form of communication between the birth parents and adoptive parents; common among children

ovulation stimulation

an intervention for infertility that consists of drugs that stimulate multiple egg release

what are the hormonal methods of birth control?

combined oral contraceptive pill, progestin-only contraceptive pill, patch, rings, deop shot, nexplanon, and mirena, kyleena, and skyla IUDs

non-latex condoms

condoms that are animal based and do not provide protection against STD's

what type of vaginal secretions indicate fertility?

copious, thin, and stretchy/watery under influence of estrogen

what indicates ovulation?

during ovulation, the cervix is high or deep in the vagina. The os is slightly open during ovulation. Under the influence of estrogen during ovulation, the cervical mucus is copious and slippery and can be stretched between two fingers without breaking.

A nurse is conducting education classes at the local high school on reproductive life planning. Which would be appropriate for the nurse to implement during the teaching? Select all that apply.

encouragement of abstinence proper condom application sexually transmitted infection statistics

combined oral contraceptive pill

estrogen and progesterone containing hormonal method of contraception that is 92% effective with typical use and generally contains 21 hormone-containing pills followed by 7 placebo pills to create a withdrawal bleed that works by increasing the viscosity of cervical mucus, suppressing ovulation, and thinning the uterine lining

how often should silicone diaphrams be replaced instead of just washed?

every 2 years

how often does one have to breastfeed for lactational amenorrhea to be effective at preventing pregnancy?

every 4 hours

emergency contraception

hormonal contraception that is taken within 72 hours of unprotected sex that can be available as a medication or a copper IUD; works by preventing embryo creation and uterine implantation

progesterone-containing methods

hormonal contraceptive methods that can be used during breastfeeding and consist of the progestin-only contraceptive pill, mirena, kyleena, and skyl IUDs, depoprovera shot, and nexplanon implant

estrogen-containing methods

hormonal contraceptive methods that cannot be used during breastfeeding and consist of the combined oral contraceptive pill, annovera ring, nuva ring, and patch; they work by suppressing the mid-cycle secretion of LH, preventing ovulation and suppress the secretion of FSH preventing folliculogenesis

when should emergency contraception be considered with COC?

if hormonal pills were missed during the first week and unprotected sexual intercourse occurred in the previous 5 d.

oligoovulation

infrequent/irregular ovulation

Nanoxynol-9

jelly, cream, suppository, or film that contains a chemical that kills sperm and that is inserted into the vagina prior to intercourse to prevent pregnancy. should be inserted atleast 10 minutes before sexual intercourse. Women often use it in conjunction with other products since used alone it is not very effective; Women using spermicide are more prone to urinary tract infections and vaginal irritation and inflammation. This inflammation and irritation makes women more vulnerable to infection with STIs, including human immunodeficiency virus.

late COC pill

less than 24 hours since it should have been taken

how are essure and adiana confirmed?

low pressure HSG

lactational amenorrhea

method of birth control that is 98% effective for 6 months after delivery if one exclusively breastfeeds, has not experienced menses 56 days postpartum, and breastfeeds every 4 hours

what are the adverse affects of EC?

nausea, vomiting, headache, and irregular bleeding

how early before intercourse should the diaphram be placed?

no less than 2 hours prior

A nurse is talking to an adolescent who informs the nurse about being sexually active and wanting some type of birth control. Which option should the nurse recommend to this client?

oral contraceptive pills (OCPs) Birth control pills are most effective for the adolescent age group. Condoms, both male and female, are easily accessible but less effective with more potential for error in use. An intrauterine device requires medical placement and follow-up and, as such, is not the best choice for an adolescent.

what are the benefits of COC?

protection against pelvic inflammatory disease reduced risk for endometrial cancer (+ovarian) improvement in acne

A client is scheduling a date for an intrauterine insemination after 18 months of being unable to conceive with her spouse. The nurse evaluates that the client understands the procedure when the client notes which action(s) as important in preparing for this procedure? Select all that apply.

recording basal body temperature (BBT) assessing cervical mucus using an ovulation predictor kit

barrier methods

short-term and non-hormonal contraceptive methods that include condoms, diaphragms, spermicide, natural family planning, lactation awareness method, and withdrawl

how are fertility days calculated?

subtract 18 from the shortest period and subtract 11 from the longest period

what vaginal secretions appear before ovulation?

thick, white and dry before ovulation

what are the symptoms of nexplanon?

unscheduled bleeding; can be treated with a short course of NSAIDS, COCs or supplemental estrogen

how long should the cervical cap be left in?

up to 6 hours before sex and removed 6-48 hours after

what are the sites a hormonal patch can be placed?

upper back, upper arm, upper buttock, and lower abdomen

Multiphasic oral contraceptives

vary the estrogen and/or progestin dosing over the course of the month.

what are the symptoms that can be caused by the contraceptive ring?

venous thromboembolism, toxic shock, and vaginal symotoms

how often should hormonal patch sites be rotated to prevent skin irritation, breakdown, and increase absorption?

weekly

what population are the cervical cap and diaphram most effective for?

women who have not given birth

If a woman presents for injection more than _______ weeks after her last injection, she should take a pregnancy test prior to administration and use a backup method of contraception for ______ days following administration

15 weeks, 7 days

missed COC pill

24-48 hours since pill should have been taken

when should a copper IUD be inserted after having unprotected sex to be used as emergency contraception?

5-7 days

a woman is considered fertile _________ days prior to ovulation and ____________ hours after ovulation

5; 24

If the COC is taken ________ days after the start of menses it is considered effective immediately ; if it has been more time she should rely on a backup method for _________ daus

5; 7

how long should the diaphram be left in after intercourse?

6 hours

pregnancy can occur within _________ days of a missed pill in a progestin-only pill pack

7

when should a women ideally start depoprovera within the start of her last menstrual cycle?

7 days

within how long after unprotected sex does one need to take levonorgestrel (plan B)?

72 hours

which days of the menstrual cycle is intercourse avoided when using the natural family planning/rhythm method/standard days method?

8-19; unprotected sex may occur on the remaining days --> good for women whose cycle ranges from 26-32 days but bad for those who have irregular menses

CycleBeads

CycleBeads is a natural fertility awareness method in which a woman uses a special circle of beads that helps her predict fertile days so that she can abstain from sex on those days. This method meets all of the requirements of the couple. Lactation amenorrhea is a natural method, but it would not apply in this situation, as the woman is not currently breastfeeding. Coitus interruptus is also a natural method, but it is not a fertility awareness method. Vasectomy is a surgical procedure that results in permanent sterility. As the couple would like to have children in the future, this method would not be appropriate.

A client received a scheduled dose of depot medroxyprogesterone acetate (DMPA) 6 weeks ago. Today, the client reports that a regular menstrual cycle is 2 weeks late. What is the first thing that should be done for this client?

Perform a pregnancy test. Because the client is receiving a contraceptive that could cause amenorrhea, and the client's menstrual cycle is 2 weeks late, the first thing that should be done is a pregnancy test to determine if the client is pregnant. The results of this test will determine the next course of action. Depot medroxyprogesterone acetate (DMPA) is a pregnancy category X medication, which means it should not be administered to someone who is pregnant. It is unclear if the client was already pregnant when the last dose was provided 6 weeks prior to the current situation. It is premature to provide prenatal counseling. Depending on the results of the pregnancy test, the nurse may need to explain side effects of the contraceptive, which include amenorrhea.

contraceptive sponge

a barrier method of contraception that consists of a 2-inch round spermicide-infused foam disk that fits over the cervix and is wet prior to insertion and then inserted with fingers into the vagina; placed with the dimple over the cervix and the ribbon side down for later ease of removal

male condoms

a barrier method of contraception that provides the best protection against STIs and should be applied prior to genital contact but have a high failure rate for preventing pregnancy; it should be placed with some room at the tip to leave for ejaculation when the penis is erect and should be removed from the base to avoid semen leakage

scheduled withdrawl bleed with COC

a bleed that occurs due to the 7 placebo pills in a COC due to hormone levels dropping

infertility

a condition that is defined as a lack of pregnancy after 12 months of well-timed intercourse or 6 months if the woman is 35 years old; can lead to psychological effects as well such as emotional instability and loss of intimacy between a couple since sex starts to feel more like a chore than something enjoyable

Annovera, NuvaRing

a contraceptive flexible silicone ring that consists of an estrogen and progestin that provides long term protection for 13 cycles and is inserted for 21 continuous days and removed for 7 days to create a withdrawl bleed or can alternatively be placed for 4 weeks and then immediately replace with a new ring to experience spotting instead.

vacuum aspiration

a surgical abortion that can be obtained up to 16 weeks after one's last menstrual period

levonorgestrel (plan B)

a type of emergency contraception that consists of a medication available over the counter or by prescription that is most effective when taken within 72 hours (70-120 hours = reduced efficacy) of unprotected sex that prevents ovulation and does not affect an existing pregnancy

ulipristal (ella)

a type of emergency contraception that consists of medication available by prescription only that may be used within 120 hours of unprotected sex that works as a progestin blocker

what are the contraindications for estrogen - progesterone methods?

migraine with aura, HTN, and smoking after the age of 34

what are the contraindications to the combined oral contraceptive pill?

migraine, history of blood clots, hypertension, smoking over 30, liver or heart disease, and gastric bypass surgery

how often should women check for string placement with an IUD?

monthly

what cannot be used with latex condoms?

oil-based substances

Gonadotropins

particularly letrozole, are a common second-line choice after clomiphene citrate failure; self injection via IV or SUB Q

Because Ulipristal acts as a ____________ blocker, if one chooses to restart hormonal method of contraception it should begin _____ days after taking and should be used _______ days before relying on it for birth control ----> this means the patient should plan to use abstinence or barrier method of contraception for _______ days after taking Ulipristal

progestin, 5 days, 7 days, 12 days

OHSS (ovarian hyperstimulation syndrome)

relatively common side effect of ovarian stimulation is OHSS, which includes the enlargement of the ovaries with multiple cysts and the accumulation of abdominal fluid associated with hypovolemic shock, acute respiratory distress, renal failure, thromboembolic, and death

osmotic dilatiors

used for later abortion procedures; used 12 -18 hours prior to the procedure

what are the symptoms of depoprovera injections?

weight gain, bone loss, and infrequent menses, worsen headacesm worsen depression and those with preexisting hx of mood disorders or premenstrusl dysphoric disorder

what are the contraindications to copper and hormonal IUDS?

women with abnormalities of the uterine cavity, endometrial cancer, untreated ovarian cancer, persistent gestational trophoblastic disease, current PID or pelvic tuberculosis, current postabortion sepsis, abnormal vaginal bleeding suspicious for malignancy, or pregnancy

medium cervical cap

for women who have had an abortion or cesarean birth

intrauterine contraceptive devices (IUDs)

hormonal contraceptive methods that consist of T shaped plastic device wrapped in copper and containing progestin that are inserted into the uterus that alter tubal transportation, are toxic to ovum, incapacitate sperm, and produce an inhospitable environment for implantation

A client is desiring to start birth control and is questioning the nurse concerning the best options. Which option should the nurse point out is the most reliable? diaphragms condoms oral contraceptive pills (OCPs) hormonal implant

hormonal implant

when is backup contraception needed with missed COC?

if 2 or more pills are missed consequetively

small cervical cap

indicated for women who have never been pregnant

hyperosalpingography

is an imaging test used to assess the fallopian tubes and uterus. During the test, a water- or oil-based contrast medium is introduced into the uterus. Imaging is used to track the path of the contrast medium and determine if there is a structural abnormality of the uterus or fallopian tubes or a blockage of one or both tubes; radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix

what are the risks of an IUD?

perforation of the uterus, mild-moderate cramping/pain in the first week after insertion, spontaneous expulsion of the IUC from the uterus to the cervix

family planning

planning that includes educational, social, or health care interventions that allow people to plan reproduction and can consist of contraception, abortion, and suberfertility/infertility care

white powder

prevents lint accumulation on adhesive patches

bilateral tubal ligation

process of female sterilization in which the fallopian tubes are either tied and cut, banded, or catheterized

vasectomy

process of male sterilization in which the vas deferense transporting sperm from the epididimis are cut and cauterized to ensure blockage of the passage of sperm; Relatively easy procedure with few complications; most cost effective and safe; usually an office procedure still ejaculates still produce sperm

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation?

a diaphragm and spermicide Women over 40 who smoke should not take ovulation suppressants; irregular menstrual cycles make natural methods difficult; women over 40 may have vaginal dryness, so a spermicidal suppository would not be activated.

progestin-only contraceptive pill (mini-pill)

a hormonal contraceptive method that consists of a 28 pill pack containing only progesterone that must be taken within a 3-hour window each day to be effective; can cause a less regular period and more breakthrough bleeding; usually given to women who cannot take estrogen

nexplanon/Implanon implant

a hormonal contraceptive method that consists of a 4 cm nonestrogen etonogestrel that is inserted under the skin in the inner upper arm that is approved for 3 years of use and creates changes in cervical mucus and fallopian tube motility to impede fertilization and suppresses follicle maturation and ovulation

depoprovera injection (contraceptive injection)

a hormonal contraceptive method that consists of progestin-only (medroxyprogesterone acetate) injection given every 13 weeks IM/SUB-Q that suppresses follicle-stimulating hormone and lutenizing hormone to inhibit follicle maturation and ovulation; should not be massaged since it should absorb SLOW

diaphragm

a mechanical barrier method of birth control that consists of a flexible saucer (LATEX) that is placed in the vagina to cover the cervix and is used with spermicide; more effective than condoms but does not protect against STI's; available by prescription only.

copper IUD

a nonhormonal contraceptive method that can be used as emergency contraception when inserted within 5 days of unprotected sex and is effective for 10 years

Cervical Cap (FemCap)

a rubber cap (LATEX) that fits over the cervix, used with spermicide to prevent conception shaped like a small cup rather than a saucer; comes in small, medium and large sizes

clomiphene citrate

a selective estrogen receptor modulator and common first-line medication to induce ovulation that is usually started 5 days after the start of menses; can cause overstimulation of ovaries

adiana

a silicone matrix used in female sterilization to mechanically block the fallopian tubes

dilation and curettage

a surgical abortion that can be obtained up to 14 weeks after one's last menstrual period

A nurse is counseling women on birth control choices. Which woman is the best candidate for an IUD?

a woman who has one partner and three children

extended cycling

an alternative method of combined oral contraceptive pill use that consists of taking 84 hormonal pills followed by 7 placebo pills; used when women wish to have fewer periods, or as a strategy to minimize symptoms of endometriosis, menstrual migraines, hyperandrogenism, or premenstrual dysphoric disorder; increases the number of days of taking estrogen-progestin pills to limit the number of days of withdrawal bleeds during placebo days

hormonal patch (Xulane)

an estrogen-progesterone containing hormonal contraceptive method that consists of a patch applied weekly for 3 weeks followed by a patch-free week to create a withdrawl bleed or alternatively can be used for four weeks to allow for extended cycling

intracytoplasmic sperm injection (ICSI)

an infertility intervention that consists of injecting a single sperm into an egg; It is used to achieve pregnancy in the case of poor sperm motility, high levels of abnormal sperm morphology, oligospermia, and for men who produce but do not ejaculate sperm

intrauterine insemination (IUI) (artificial)

an intervention for infertility that consists of ejaculated sperm is washed and removed of prostaglandins and semen proteins then contrated in culture media and placed directly into the uterus by personnel; done just prior to natural or induced ovulation

Gamete intrafallopian transfer (GIFT)

an intervention for infertility that consists of removing a woman's egg and mixing it with sperm and placing it back in the fallopian tube; wouldn't work for someone with damage to this

in-vitro fertilization (IVF)

an intervention for infertility that consists of the process of fertilization by manually combining an egg and sperm in a laboratory dish after stimulating the ovaries to produce eggs and then transferring the embryo to the uterus

long-acting reversible contraception

contraceptive methods that consist of IUDs, implants, combined oral contraceptive pills, progestin-only contraceptive pills, hormonal patches, hormonal vaginal rings, and contraceptive injections

non-reversible contraceptive methods

contraceptive methods that include vasectomies, hysterectomies, and tubal ligation