Family Planning & Contraception

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Miriam Wahrman
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Included In This Lesson

Study Tools For Family Planning & Contraception

Intra Uterine Device – Potential Problems (Mnemonic)
Oral Birth Control Pills – Serious Complications (Mnemonic)
Oral Contraceptive (Image)
Contraceptive Patch (Image)
Family Planning (Cheatsheet)
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Outline

Overview

  1. Family planning consists of multiple ways  to plan or prevent pregnancy from occurring.

Nursing Points

General

  1. It is important to remember the patient’s preferences are most important and the below factors may influence choices of family planning
    1. Goal-oriented in selection of method
      1. Prevention versus planning
    2. Factors that may influence contraceptive selection:
      1. Religious, cultural, personal influences
      2. Age
      3. Smoker or nonsmoker
      4. Goals for family planning
      5. Level of compliance (for example, will she take an oral contraceptive every day?)
      6. Frequency of intercourse (for example, if someone is frequently having intercourse, will they use a condom every time or would an oral contraceptive or IUD be more appropriate?)
      7. Currently breastfeeding
  2. The only method that is 100% proven to prevent pregnancy or STI’s is abstinence

Assessment

  1. Assess their current lifestyle / habits
  2. Identify their family planning goals

Therapeutic Management

  1. Pregnancy prevention
    1. Oral contraceptives, intrauterine devices, cervical caps, diaphragm
  2. Pregnancy and STI prevention
    1. Condoms
  3. Trying to get pregnant
    1. Ovulation tracking
      1. Basal Body Temperature
      2. Ovulation Predictor Kits
      3. Calendar Method
    2. Infertility
      1. Meds
      2. Surgical procedures
        1. To fix whatever the problem is ie: blockage in the tubes carrying the sperm
      3. In vitro fertilization
      4. Intrauterine insemination
      5. Surrogacy
      6. Embryo hosts
      7. Adoption
  4. Finished having children and want to permanently prevent future pregnancy
    1. Tubal ligation (female)
    2. Vasectomy (male)

Nursing Concepts

  1. Reproduction
  2. Patient education

Patient Education

  1. Birth control pills should be taken at the same time every day
  2. Antibiotics and other meds may decrease the effectiveness of contraceptives – use other form of protection
  3. It is important to take a prenatal vitamin when trying to conceive – should include folic acid

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Transcript

So what does Family Planning actually mean? Well with this it just means that it could be a person is either trying to prevent a pregnancy from occurring or someone that’s trying to plan a pregnancy. So we are going to talk about several different considerations that need to be taken in and then also how to make them successful in what they have chosen for themselves.

So let’s first talk about the patient that wants contraception so this patient is not trying to get pregnant. What are the considerations that we need to take into account when trying to help her with this? So there are a few big things I’ll write out for you. We need to know if she has any religious or cultural preferences because that could affect our choice and decision with her. We need to know her age. Some medications or contraception such as the oral contraception pills are not going to be good for somebody that is older because of hormones and blood clot risk. Also we need to know if she’s a smoker, why? Same thing the oral contraception won’t be good for that type of patient because we worry with oral contraception about blood clots forming and so someone that smokes is going to be at an increased risk. We also need to know if she has risky sexual behavior and by this we mean someone that has multiple partners. Somebody that has risky sexual behaviors would not be the best patient have something like an intrauterine device(IUD) placed as birth control because we worry about pelvic infections with these patients and those that have multiple partners are more at risk for STI and pelvic infections so adding that to the fact that they have a foreign body implanted would put them more at risk. And the last consideration is is this patient breastfeeding? So maybe they’ve had a child already and they are breastfeeding them and they need birth control because they don’t want to have another baby quite yet. For them the best option is going to be something called the mini pill and this is just like a progesterone only pill that won’t to hinder their milk supply. When contraception is being discussed with a patient we need to find what is going to best work for them and for their situation but the one thing that always needs to be stressed to the patient is that the only way to be 100% effective in preventing pregnancy or from getting an STI would be abstinence.

Now you have a patient that actually wants to be pregnant and needs advice on how to do this. There’s a few different ways that women can track ovulation because if they know when they ovulate and have intercourse around that time then hopefully they’ll be more successful getting pregnant. The first way we’ll talk about is the basal body temperature tracking. This patient will track her temperature every day now it has to be at the same time everyday before rising out of bed okay so that’s the basal body temperature tracking. When she takes her temperature and it’s ovulation time her body temperature is going first drop and then rise about 0.4-1 degree higher than what it had been. This temperature rise means that ovulation has occurred. So let’s review what your basal body temperature needs to be taken everyday at the same time before rising out of bed you will notice that your temperature range is about the same and then you will have a drop in temperature right as the egg is being released from the ovary and then the temperature will rise and that means ovulation has occurred. There are also ovulation predictor kits that women can buy from a drugstore where they void on a stick and it lets them know whether or not they are ovulating. and the last method for women that are trying to track for pregnancy would be the calendar method. With the calendar method they’re going to track their menstrual cycles over several months to get an idea of when ovulation is occurring based on how long their cycles are and knowing that ovulation occurs around the 14th day of a cycle.

Let’s compare now some more permanent methods for contraception. First we have vasectomy so here the vas deferans is cut and cauterized so that the male become sterile. It is important to know that this is not an instant fix it’s about three months before they will say that the male is sterile. And he will need to undergo to sperm counts to verify that there are no more working sperm there. This is outpatient and he will just need to ice and take it easy for a few days. For the woman she can have a tubal ligation or sometimes also called tubes tied so with this the fallopian tubes are clamped and tied so this way no egg can travel through the tube and this will sterilize the woman. Female this is a little bit more of an intense procedure where she’s going to need a lot more rest time to some women will do this after they’ve had their last baby if they delivered by C-section since the doctors already in there but otherwise this will cause a lot more pain and recovery in comparison to a vasectomy being done.

There are a few key points to try to remember. It is important to always consider the patient’s lifestyle in any type of family planning to know what’s best going to work for them. What is the patient trying to do what is their ultimate goal? Do they want to plan a pregnancy or prevent pregnancy? Based on their ultimate goal there are many options for them so it is our job to find what is going to be best for them and that they can stick with.

Reproduction and patient education will be the nursing concepts for this. Obviously with family planning we are talking about reproduction either how to make it happen or how to prevent it. And there is a lot of patient education that goes into this. With family planning they have to be able to be compliant and use the right things to be preventative if that’s what they wish and then also education on becoming pregnant.

Make sure you check out the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing.

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Study Plan for Study Skills, Test Taking for the NCLEX® Using Med-Surg (Lewis 10th ed.) designed for Westmoreland County Community College

Concepts Covered:

  • Concepts of Population Health
  • Factors Influencing Community Health
  • Community Health Overview
  • Substance Abuse Disorders
  • Upper GI Disorders
  • Renal Disorders
  • Newborn Care
  • Integumentary Disorders
  • Tissues and Glands
  • Central Nervous System Disorders – Brain
  • Digestive System
  • Urinary Disorders
  • Urinary System
  • Musculoskeletal Trauma
  • Concepts of Mental Health
  • Health & Stress
  • Developmental Theories
  • Fundamentals of Emergency Nursing
  • Communication
  • Basics of NCLEX
  • Test Taking Strategies
  • Prioritization
  • Delegation
  • Emotions and Motivation
  • Integumentary Disorders
  • Legal and Ethical Issues
  • Basic
  • Preoperative Nursing
  • Labor and Delivery
  • Fetal Development
  • Newborn Complications
  • Postpartum Complications
  • Postpartum Care
  • Labor Complications
  • Pregnancy Risks
  • Prenatal Concepts
  • Circulatory System
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Shock
  • Postoperative Nursing
  • Intraoperative Nursing
  • Oncology Disorders
  • Neurological Emergencies
  • Respiratory Disorders
  • Female Reproductive Disorders
  • Acute & Chronic Renal Disorders
  • Liver & Gallbladder Disorders
  • Lower GI Disorders
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Immunological Disorders
  • Hematologic Disorders
  • EENT Disorders
  • Integumentary Important Points
  • Musculoskeletal Disorders
  • Emergency Care of the Neurological Patient
  • Peripheral Nervous System Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Neurologic and Cognitive Disorders
  • Eating Disorders
  • Noninfectious Respiratory Disorder
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Psychological Emergencies
  • Trauma-Stress Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Bipolar Disorders
  • Depressive Disorders
  • Psychotic Disorders
  • Anxiety Disorders
  • Somatoform Disorders
  • Infectious Disease Disorders
  • Musculoskeletal Disorders
  • Renal and Urinary Disorders
  • Cardiovascular Disorders
  • EENT Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Oncologic Disorders
  • Endocrine and Metabolic Disorders
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Medication Administration
  • Nervous System
  • Dosage Calculations
  • Learning Pharmacology
  • Prefixes
  • Suffixes

Study Plan Lessons

Communicable Diseases
Disasters & Bioterrorism
Cultural Care
Environmental Health
Technology & Informatics
Epidemiology
Health Promotion & Disease Prevention
Head to Toe Nursing Assessment (Physical Exam)
Enteral & Parenteral Nutrition (Diet, TPN)
Specialty Diets (Nutrition)
Blood Glucose Monitoring
Intake and Output (I&O)
Hygiene
Pain and Nonpharmacological Comfort Measures
Bowel Elimination
Urinary Elimination
Complications of Immobility
Patient Positioning
Defense Mechanisms
Overview of Developmental Theories
Abuse
Therapeutic Communication
Overview of the Nursing Process
Triage
Prioritization
Delegation
Maslow’s Hierarchy of Needs in Nursing
Isolation Precaution Types (PPE)
Fall and Injury Prevention
Fire and Electrical Safety
Brief CPR (Cardiopulmonary Resuscitation) Overview
HIPAA
Advance Directives
Legal Considerations
Process of Labor
Fetal Circulation
Fetal Environment
Newborn of HIV+ Mother
Hyperbilirubinemia (Jaundice)
Transient Tachypnea of Newborn
Meconium Aspiration
Babies by Term
Newborn Reflexes
Body System Assessments
Newborn Physical Exam
Postpartum Hemorrhage (PPH)
Mastitis
Initial Care of the Newborn (APGAR)
Breastfeeding
Postpartum Discomforts
Postpartum Physiological Maternal Changes
Dystocia
Precipitous Labor
Preterm Labor
Abruptio Placentae (Placental abruption)
Placenta Previa
Prolapsed Umbilical Cord
Fetal Heart Monitoring (FHM)
Leopold Maneuvers
Mechanisms of Labor
Fetal Development
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Gestational HTN (Hypertension)
Hydatidiform Mole (Molar pregnancy)
Ectopic Pregnancy
Disseminated Intravascular Coagulation (DIC)
Gestational Diabetes (GDM)
Nutrition in Pregnancy
Chorioamnionitis
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Maternal Risk Factors
Fundal Height Assessment for Nurses
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates
Family Planning & Contraception
Menstrual Cycle
Hemodynamics
Normal Sinus Rhythm
Performing Cardiac (Heart) Monitoring
Preload and Afterload
Sinus Bradycardia
Sinus Tachycardia
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Angina
Pacemakers
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Discharge (DC) Teaching After Surgery
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Malignant Hyperthermia
Moderate Sedation
Local Anesthesia
Preoperative (Preop)Assessment
General Anesthesia
Preoperative (Preop) Nursing Priorities
Preoperative (Preop) Education
Informed Consent
Biopsy
Ultrasound
Echocardiogram (Cardiac Echo)
Cardiovascular Angiography
Cerebral Angiography
Magnetic Resonance Imaging (MRI)
X-Ray (Xray)
Computed Tomography (CT)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Dialysis & Other Renal Points
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Pancreatitis
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Diabetes Management
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Addisons Disease
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Oncology Important Points
Lymphoma
Leukemia
Blood Transfusions (Administration)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Glaucoma
Macular Degeneration
Hearing Loss
Fractures
Cataracts
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Burn Injuries
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Seizure
Seizure Therapeutic Management
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Stroke Nursing Care (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Therapeutic Management (CVA)
Stroke Assessment (CVA)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Miscellaneous Nerve Disorders
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Cerebral Perfusion Pressure CPP
Intracranial Pressure ICP
Adjunct Neuro Assessments
Levels of Consciousness (LOC)
Routine Neuro Assessments
Hemoglobin A1c (HbA1C)
Glucose Lab Values
Urinalysis (UA)
Creatinine (Cr) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Ammonia (NH3) Lab Values
Cholesterol (Chol) Lab Values
Albumin Lab Values
Coagulation Studies (PT, PTT, INR)
Platelets (PLT) Lab Values
White Blood Cell (WBC) Lab Values
Hematocrit (Hct) Lab Values
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Chloride-Cl (Hyperchloremia, Hypochloremia)
Sodium-Na (Hypernatremia, Hyponatremia)
Potassium-K (Hyperkalemia, Hypokalemia)
Hypertonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Isotonic Solutions (IV solutions)
Base Excess & Deficit
Metabolic Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Respiratory Alkalosis
Respiratory Acidosis (interpretation and nursing interventions)
ABG (Arterial Blood Gas) Interpretation-The Basics
ABGs Nursing Normal Lab Values
Chest Tube Management
Nursing Care and Pathophysiology of Pneumonia
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Nursing Care and Pathophysiology for Asthma
Suicidal Behavior
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Mood Disorders (Bipolar)
Depression
Schizophrenia
Generalized Anxiety Disorder
Post-Traumatic Stress Disorder (PTSD)
Somatoform
Dissociative Disorders
Anxiety
Pertussis – Whooping Cough
Varicella – Chickenpox
Mumps
Rubeola – Measles
Scoliosis
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Disorders
Spina Bifida – Neural Tube Defect (NTD)
Meningitis
Enuresis
Nephrotic Syndrome
Cerebral Palsy (CP)
Mixed (Cardiac) Heart Defects
Obstructive Heart (Cardiac) Defects
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Congenital Heart Defects (CHD)
Cystic Fibrosis (CF)
Asthma
Acute Otitis Media (AOM)
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Tonsillitis
Conjunctivitis
Constipation and Encopresis (Incontinence)
Intussusception
Appendicitis
Celiac Disease
Pediatric Gastrointestinal Dysfunction – Diarrhea
Vomiting
Hemophilia
Nephroblastoma
Fever
Dehydration
Sickle Cell Anemia
Burn Injuries
Pediculosis Capitis
Impetigo
Eczema
Growth & Development – School Age- Adolescent
Growth & Development – Preschoolers
Growth & Development – Toddlers
Growth & Development – Infants
Care of the Pediatric Patient
Vitals (VS) and Assessment
Vasopressin
TCAs
SSRIs
Proton Pump Inhibitors
Vancomycin (Vancocin) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Parasympatholytics (Anticholinergics) Nursing Considerations
NSAIDs
Nitro Compounds
MAOIs
Hydralazine (Apresoline) Nursing Considerations
Insulin
Magnesium Sulfate
HMG-CoA Reductase Inhibitors (Statins)
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
Epoetin Alfa
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Corticosteroids
Benzodiazepines
Cardiac Glycosides
Calcium Channel Blockers
Parasympathomimetics (Cholinergics) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Autonomic Nervous System (ANS)
Atypical Antipsychotics
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System
Complex Calculations (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Injectable Medications
Oral Medications
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
The SOCK Method – K
The SOCK Method – C
The SOCK Method – O
The SOCK Method – S
The SOCK Method – Overview
6 Rights of Medication Administration
Essential NCLEX Meds by Class
12 Points to Answering Pharmacology Questions
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
54 Common Medication Prefixes and Suffixes