Video #1: Contraception & Infertility

Ø Diaphragms: client must be refitted for a diaphragm for the following conditions:

1.) Its been 2 years since she’s been fitted

2.) Gained more than 15 pounds (7kg)

3.) Had a full term pregnancy

4.) Had a second term abortion

o When you use a diaphragm, you need to use spermicide with every act of coitus

(withdrawal of penis from vagina prior to ejaculation). Every time you withdrawl, instill

more spermicide

o Diaphragm must stay inserted for 6hrs after act of coitus

Ø Hormonal Contraceptives (Oral)

o Side effects: Chest pain, SOB, Leg pain (from a possible clot), headache or eye problems

(from a stroke or hypertension)

o Contraindications: Women with a history of blood clots, stroke, cardiac problems, smoker,

breast or estrogen related cancers (pill contains estrogen)

Ø Depo-Provera/Medroxyprogesterone

o Injectable progestin

o Can cause decreased bone mineral density or loss of calcium

§ Nursing action: Ensure patient has adequate intake of calcium and vitamin D

Ø IUD

o Increase risk for PID

o Can cause uterine perforation or ectopic pregnancy (increases risk for ectopic pregnancy)

o Look out for/Notify PCP:

§ Change in string length à IUD is moving and not in the right place

§ Foul smelling vaginal discharge

§ Pain with intercourse

§ Fever/Chills (infection)

Infertility is defined as an inability to conceive desire engaging in unprotected sexual intercourse for a

prolonged period of time or at least 12 months.

Ø Common factors associated with infertility include:

o Decreased sperm production (Sperm analysis)

o Endometriosis

o Ovulation disorders

o Tubal occlusions à If you test and use DYE (used in the fallopian tubes), make sure the woman

is not allergic to iodine or shellfish/seafood

Video #2: Signs of Pregnancy

Presumptive: Can be defined by things/reasons other than pregnancy

Ø Amenorrhea à Can be anorexic or exercising too much

Ø Fatigue à Didn’t sleep well

Ø Nausea/Vomiting à Sick

Ø Urinary Frequency à UTI

Ø Quickening/Fluttering in stomach à Gas

Probable: Changes that make the examiner suspect a woman is pregnant (primarily related to physical

changes of the uterus).

Ø Abdominal enlargement: Related to changes in uterine size, shape, and position

Ø Hegar’s Sign: Softening and compressibility of the lower uterus