3. Contraception - prevention of fertility on a temporary basis Sterilization - permanent prevention of fertility Female and male sterilization procedures Some procedures can be reversed but with possible complications and variable success rates It is best to include both partners in any contraception decision
26. NURSING ALERT Warn patients who use condoms, diaphragms, and the cervical cap that latex sensitivity may be a problem Watch for itching, swelling, generalized reactions
27. Condom (male and female) Latex or polyurethane or processed collagenous tissue sheaths Placed over erect penis to prevent semen from entering vagina Female condom is placed in the vagina Place condom over erect penis
63. IUD Small device made of plastic with exposed copper or progesterone-release system Acts to inhibit uterine wall implantation Health care provider inserts device; slowly and usually at time of menses Check intrauterine device string regularly (at least once per month) or after each intercourse when it is first inserted
64.
65. Advantages Disadvantages Failure rate low, 2% or less Convenient Permits spontaneous intercourse Replaced every 10 years, depending on manufacturer recommendations Risk of PID and resultant tubal damage and infertility May cause spotting, bleeding, or pain Risk of spontaneous abortion Risk of uterine rupture (rare)
68. Combination Oral Contraceptives Tablets containing estrogen to inhibit ovulation and progestin to make cervical mucus impenetrable to sperm Lowest effective doses are used Take for 21 days with 7 days off Or 28 days (if 7 days of placebos are included)
69.
70. Decreased risk of endometriosis, ovarian and endometrial cancer, benign breast disease
119. Advantages Disadvantages Convenient Only 0.3% failure rate Requires every 3-month follow-up May cause irregular bleeding, spotting, amenorrhea Long-term effects still unknown High discontinuation rate in adolescents due to adverse effects and missed appointments
120. Combination Hormonal Injection Estrogen and progesterone in long-acting injection form Initial injection within 5 days of menses, then every 28-30 days
127. RU-486 (Mifepristone) Drug that prevents implantation and leads to menses (medical abortion) Given orally within 10 days of a missed period May be combined with prostaglandin suppository
141. Complications Failure to successfully block the tubes Pregnancy or tubal pregnancy Hemorrhage Infection Uterine perforation Damage to bowel, bladder, or aorta
142. Nursing Interventions Assess motivation for sterilization and level of knowledge about the procedure Counsel as necessary Teach patient there is no effect on hormones and menstruation will continue Teach patient there should not be any adverse effect on sexual response
143. Other birth control methods are discontinued immediately before the procedure Prepare the patient to expect some abdominal soreness for several days Instruct her to report any bleeding, increasing pain, or fever Sexual intercourse and strenuous activity should be avoided for 2 weeks
154. Vasectomy Male sterilization Ligation and transection of part of the vas deferens, with or without removal of a segment of the vas deferens The spermatozoa, which are manufactured in the testes, cannot travel up the vas deferens after this surgery.
