MCN MODULE 3

• Family planning


  Voluntary and moral management of all the processes of family life including human reproduction
• Contraceptives


  Products used to prevent pregnancy by women and men
• Amenorrhea


  Markedly diminished menstrual flow
• Assessing client for family planning


  1. Perform pregnancy test

  2. Assess OB history

  3. Assess needs, preferences, desires, and feelings

  4. Assess sexual practices

  5. Assess for allergies
• Menorrhagia


  Excessive bleeding during regular menstruation
• Menometrorrhagia


  Prolonged at irregular interval
• Family planning must be moral so as not to allow doubt and anxiety in man's conscience
• Metrorrhagia


  Irregular and frequent interval but amount is variable
• Polymenorrhea


  Frequent menstruations occurring at intervals of less than 3 weeks
• Nurse's role in family planning


  • Be familiar with application, advantages and disadvantages of various contraceptive methods
  • Provide contraceptive advice without moral judgement
  • Arrange private setting
• Oligomenorrhea


  Menstruations occurring at intervals of more than 35 days
• Natural family planning (NPF) and fertility awareness method


  Contraceptive approach involving no introduction of chemical or foreign material into the body or abstaining from sexual intercourse during fertile period
• Methods of determining fertile period


  • Calculating based on set formula
  • Measuring basal body temperature
  • Observing cervical mucus
  • Using ovulation test kit
  • Combination of these methods
• Abstinence


  Refraining from sexual relations, has 0% theoretical failure rate but difficult for many to adhere to
• Use of no contraceptive has 85% failure rate
• Promoting abstinence

  1. Discuss with partner in advance

  2. Avoid high-pressure situations

  3. Say "no" firmly if pressured

  4. Do not accept drugs
• Calendar (Rhythm) method


  Couple abstains from coitus on days when woman is most likely to conceive, based on tracking menstrual cycles
• Dysmenorrhea


  Painful menstruation
• Perfect


  Refers to how well a specific form of birth control will prevent pregnancy in 100 women after a year has passed, if that method is used correctly every single time sex happens
• Typical or Actual Use


  Is how effective birth control is when it is used, well, typically. This rate is for 100 women, over the course of a year, having sex and using birth control every time - but maybe not following the directions for exactly how to use it correctly
• Basal body temperature (BBT) method


  Woman takes temperature each morning, notices slight dip followed by rise indicating ovulation, then abstains for next 3 days
• Limitations of BBT method


  • Many factors can affect BBT and lead to mistaking fertile days
  • Women with irregular schedules may have difficulty
• Cervical mucus method (Billing's method)


  Observing changes in cervical mucus to predict ovulation
• Cervical mucus becomes copious, thin, watery, and transparent at peak of ovulation
• Menstrual cycle


  • Episodic uterine bleeding in response to cyclic hormonal changes
  • Periodic recurring changes in hormonal status that prepares the body for pregnancy
  • Purpose is to bring the ovum to maturity and renew a uterine tissue bed that will be responsible for its growth and should be fertilized
  • Monthly discharge of blood from the uterus occurring from puberty to menopause wherein about 30-80 cc of blood, epithelial cells and mucus are being discharged
• Basal body temperature (BBT)


  Method to predict ovulation by monitoring changes in a woman's daily temperature
• Maturation of Oocytes


  1. First formed in utero

  2. First 5 months of intrauterine

  3. At birth

  4. 7 yrs of age only

  5. Reproductive age only

  6. Menopause
• Normal period lasts from 3 - 5 days (2 - 7 days) (short as 1 day to as long as 9 days)

  
• Basal body temperature method


  • Requires a woman to take her temperature at the same time every morning before getting out of bed
  • Changes in the woman's daily schedule can influence the BBT
• Cervical mucus method (Billing's method)


  Method to predict ovulation by monitoring changes in cervical mucus
• Cervical mucus changes during ovulation


  1. Before ovulation, mucus is thick and does not stretch

  2. Just before ovulation, mucus secretion increases and becomes copious, thin, watery, and transparent

  3. Mucus feels slippery and stretches at least 1 inch before the strand breaks (spinnbarkeit)

  4. Breast tenderness and an anterior tilt to the cervix also occur
• Cervical mucus method


  • Requires a woman to be conscientious about assessing her vaginal secretions every day
  • Failure rate is about 25%
• Menstrual cycle lasts from 21-35 days

  
• Symptothermal method


  Combines the cervical mucus and basal body temperature methods
• Average: 28 days cycle
• Symptothermal method


  1. Woman takes her temperature daily, watching for the rise that marks ovulation

  2. Woman also analyzes her cervical mucus every day and observes for other signs of ovulation

  3. Couple must abstain from intercourse until 3 days after the rise in temperature or the fourth day after the peak of mucus change
• Estrogen


  • Inhibits production of FSH
  • Causes hypertrophy and hyperplasia of myometrium
  • Stimulates the growth of ductile structures of the breast
  • Increases quantity and pH of cervical mucus causing it to become thin watery and can be to 13-15 cm (Spinnbarkeit test of dilation)
• Progesterone


  • Facilitates transport of fertilized ovum through the fallopian tubes
  • Causes fluid retention
  • Decreased hemoglobin and hematocrit levels
  • Increased basal body temp after ovulation because of the presence of progesterone
• Symptothermal method


  • More effective than either the BBT or the cervical mucus method alone, with an ideal failure rate of about 2%
• Body structures involved in menstrual cycle


  • Hypothalamus
  • Anterior pituitary gland
  • Ovaries
  • Uterus