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Prittyrick
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methods
- natural family planning also known as reversible methods
- barrier method
- hormonal method
- surgical method
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Natural family planning reversible method
- abstinence
- calendar method- 2 day method- risk for sti
- withdrawl/coitus interrupts
- fertility awareness based method:
- - symptom method: cervical mucous
- - basal body temp- decre
- - symtothermal method
- - home predictor kits
- lactational amennorrhea method- breast feeding (LAM)
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PP: LAM
- effective for 6 m only if:
- has not had period since she gave birth
- breast feeds daily on both breast 6 time/day
- breast feeds baby on demand q 4 hours at least
- does not substitute other food
- provide night time feeding every 6 hours
- do not rely on this method after 6 m
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barrier method
- condoms: males/femals
- - only method besides abstinence that will protect from sti
- the other will not protect
- - diaphram spermicides
- - cervical cap
- - contraceptive sponge
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education condoms males and females
- only one time use
- observe for expiration, tear prior to use
- keep cool
- males:
- - must leave an empty sac at tip for sperm
- - withdraw while penis is erect and hold rim of condom so u dont have spillage
- - only water soluble lubricate should be used with latex to prevent breakage
- - caution with latex condoms
- females
- - can be worn up to 8 hours after intercourse
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barrier method caution
- incr risk for toxic shock syndrome (TSS)contraindicated: women with hx of TSS
- TSS caused by a bacteria infection s/s
- - high fever, faint feeling, hypotension, watery diarrhea, headache, and muscle aches
- - may result in multi system failure and death
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Hormonal method
- rely on estrogen and progestin or progestin (only) to prevent ovulation
- methods:
- - oral contaceptives
- - injectable
- - implants
- - vaginal rings
- - transdermal patches
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Hormonal method oral
- Combined
- - estrogen and progesterone
- - suppressive ovulation, thicken cervical mucous, alter uterine endometrium
- - disad- breast tender, DVT, stoke
- Minipill
- - progesterone only
- - thickens cervical mucous- makes hostile environment
- used for women who can not take estrogen (hx of dvt, cancer,)
- - safe for breast feeding women
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hormonal method (emergency, injection
- emergency contraception
- oral: dosage with 72 hour of intercourse
- makes uterus not plantable
- dont make this the permanant method
- combined estrogen and progesterone (yuzpe regimen, planned b one step (levonorgesterol)
- cooper bearing IUS within 5 days of intercourse
- Injectable - dep provera (progesterone only)
- administer IM q 11-13 weeks
- first day of menstrual cycle
- postpartum: non breast feeding- within 5 days, breast feeding in the 6th week
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hormonal method (transdermal, rings, implanted deviced)
- Transdermal:
- patch with hormones placed on the skin
- - 3 weeks on 1 week off
- - estrogen and progesterone
- Vaginal rings:
- - hormones absorbed thru vagina epithelium
- - 3 weeks in 1 week out
- implanted devices
- - intrauterine device (IUD)
- - transcerical sterilization- put in tubes
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signs of complication hormone users ACHES
- A- abd pain may indicate gallbladder and liver problems
- C- chest pain SOB may indicate pulomonary embolism
- H- headaches, may indicate HTN or impeding stroke
- E- eye problem may indicate HTN or impeding stroke
- S- severe leg pain may indicate DVT
- mimic pregnancy
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Patient education: hormonal therapy
- do not skip dose
- meds that interfer with effectiveness:
- - antibiotics, anticonvulsants,
- combined oral contraceptives
- - contraindicated for women with hx of clots, stroke, cardiac problem, breast or estrogen related cancers, pregnancy, smoking (over 35 yrs of age)
- do not protect against STI
- adolescents the most difficult to education
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other uses for hormonal therapy
- treatment for endometriosis
- treatment for acne or hirsutism (excessive hair)
- decre incidence of eptopic pregnancy, acute PID
- decre perimenopausal symptoms, maintaining bone density
- incre menstrual cycle regularity
- reduces pregnancy related death
- treatment of dysfunction uterine bleeding and dysmenorrhea
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Surgical method
- consider sterilzation
- female: tubal ligation: (bilateral tubal ligation salpingectomy)
- - done in the operating room
- - done laparoscopic techique
- - often requires general anesthesia
- Male: vasectomy
- - done in the md's office with local anesthesia
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birth control for breast feeding mom
- natural family planning methods
- - do not rely on ovulation
- barrier method such as condoms and spermicide
- - diaphram and cervical cap will need sizing after 6 weeks
- oral contraceptive
- - mini pill- progestin
- Injectable
- - depo provera- injectable progestin
- implantable IUD
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Caution of all PP women
- combined hormonal therapy should not be prescribed
- - 21 days PP without hx of DVT
- - 42 days PP with Hx of DVT, c-section
- - related to hypercoagulation stage of pregnancy
- - not prescribe breast feeding women due to potential interfering with lacation
- use barrier method, spermicide until you know which method u want to use
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