Family Planning & Contraception

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Miriam Wahrman
MSN/Ed,RNC-MNN
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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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Concepts Covered:

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

Study Plan Lessons

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