Maternal newborn ATI Chapter 7, 8, 9

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Are diaphragms one-size-fits-all? - No, a female client should be fitted with a diaphragm properly by a provider. How long should a diaphragm be used before replacement? What other situations warrant replacement? - A client must be refitted by the provider every 2 years. If there is a 15 lb weight change, full-term pregnancy, or second-term abortion, the client should be refitted. Does the diaphragm work all by itself or do you need something else? - It should be inserted with spermicidal jelly or cream that is applied to the cervical side of the dome and around the rim. How long does the diaphragm need to be in place following coitus? - 6 hours. Should spermicide be reapplied with each act of coitus? - Absolutely. What should the client do prior to inserting the diaphragm (besides using the spermicide)? - The client should empty her bladder. Can you buy a diaphragm at the drug store? - No, a prescription and a visit to the provider is necessary. What is a major risk/possible complication of using a diaphragm? - Toxic Shock Syndrome (TSS). If you have a history of TSS, you should use a diaphragm. Risk of getting TSS goes up by using one. It's a bacterial infection. Proper hand hygiene should be observed when inserting and removing the device. What two hormones are found in combined oral contraceptives? - Estrogen + progestin How do these two hormones work to prevent conception? - Suppresses ovulation, thickening the cervical mucus to block semen, and altering the uterine deduce to prevent implantation. How does a client get access to this medication? - Requires a prescription and follow-up appointments with the provider. What side effects and danger signs should be observed? - Chest pain, shortness of earth, leg pain from a possible clot, headache, or eye problems from a stroke, or hypertension. What happens if a dose is missed? 2-3 doses? - Take the missed does as soon as possible. If 2-3 doses are missed, follow manufacturer's instructions. Use alternative forms of contraception or abstinence to precent pregnancy until regular dosing is resumed. What are the advantages to combined oral contraceptives? - Highly effective if taken correctly and consistently. Can alleviate dysmenorrhea by decreasing menstrual flow and menstrual cramp. Reduces acne. What are the disadvantages to combined oral contraceptives? - Do not protect against STIs. Can increase thromboses, breast tenderness, scant or missed menstruation, stroke, nausea, headaches, and hormone-dependent cancers. Exacerbates conditions affected by fluid retention such as migraine, epilepsy, asthma, kidney, or heat disease. What risks/possible complications exist with combined oral contraceptives? - Caution to client's with history of: blood clots, stroke, cardiac problems, breast or estrogen-related cancers, pregnancy, or smoking (if over 35 years). What medications decrease the effectiveness of combined oral contraceptives? - Those that effect liver enzymes, such as anticonvulsants and some antibiotics. What hormones make up the mini pill? - Progestins than provide the same action as combined oral contraceptives. Is ok to miss a dose of the mini pill? - No, a client CANNOT miss a pill. How often is the mini pill take? - Should be take EVERY day at the SAME time. Another form of birth control may need to be utilized during the first month of use to prevent pregnancy. Advantages of the mini pill? - Fewer side effects when compared with a combined oral contraceptive. Considered safe to take while breastfeeding

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