성장을 멈추지 마세요

체험은 만족하셨나요?

현재 45,766명이 마이메르시로 공부 중이에요

지식 자료를 소장하고 멋진 의료인으로 성장하세요

학습 자료 둘러보기 →
Contraceptives | 마이메르시 MyMerci
제안하기

뭔가 하고 싶은 말이 있는거야?

0 / 2000
컨텐츠 수정하기

컨텐츠 내용을 수정할 수 있습니다

수정하기
닫기

Contraceptives

NCLEX Review Guide: Maternity and Newborn Medications - Contraceptives

Hormonal Contraceptives Overview

Combined Oral Contraceptives (COCs)

  • Estrogen and progestin combination that prevents ovulation by suppressing FSH and LH release. Most effective when taken at the same time daily with 99% effectiveness when used correctly.
  • Contraindicated in patients with history of thromboembolism, stroke, coronary artery disease, or active liver disease due to increased clotting risk from estrogen component.

Memory Aid: ACHES

Teach patients to report: Abdominal pain, Chest pain, Headaches (severe), Eye problems, Severe leg pain

Key Points

  • Take at same time daily; backup contraception needed for first 7 days
  • Smoking increases thrombotic risk, especially in women >35 years
  • Antibiotics may decrease effectiveness - use backup method

Progestin-Only Pills (Mini-Pills)

  • Progestin-only formulation that thickens cervical mucus and may suppress ovulation. Safe for breastfeeding mothers as it doesn't affect milk production.
  • Must be taken within same 3-hour window daily for maximum effectiveness; less forgiving than combined pills regarding timing.

Key Points

  • Ideal for patients who cannot take estrogen
  • May cause irregular bleeding patterns
  • Safe during breastfeeding

Long-Acting Contraceptive Methods

Depot Medroxyprogesterone (Depo-Provera)

  • Injectable progestin given every 12 weeks intramuscularly that suppresses ovulation and thickens cervical mucus. Provides 99% effectiveness with proper administration.
  • May cause significant bone density loss with prolonged use; not recommended for more than 2 years without careful risk-benefit assessment.

Clinical Scenario

A 28-year-old patient receives Depo-Provera injection. She should be counseled about potential delayed return to fertility (up to 18 months) and the importance of calcium and vitamin D supplementation.

Key Points

  • Return to fertility may be delayed 12-18 months
  • Weight gain is common side effect
  • Bone density monitoring recommended for long-term use

Intrauterine Devices (IUDs)

  • Copper IUD (Paragard) creates hostile environment for sperm and eggs, effective for 10 years. Hormonal IUD (Mirena, Skyla) releases progestin locally, effective 3-7 years depending on type.
  • Insertion requires sterile technique and screening for STIs; cramping and spotting expected for first few months after insertion.

IUD Comparison

TypeDurationEffect on Periods
Copper (Paragard)10 yearsHeavier, longer periods
Hormonal (Mirena)7 yearsLighter periods, may stop
Hormonal (Skyla)3 yearsLighter periods

Emergency Contraception

Emergency Contraceptive Pills

  • Plan B (levonorgestrel) most effective within 72 hours but can be used up to 120 hours after unprotected intercourse. Ella (ulipristal acetate) effective up to 120 hours with consistent efficacy.
  • Does not cause abortion - works by preventing or delaying ovulation; ineffective if implantation has already occurred.

Key Points

  • Earlier administration = higher effectiveness
  • Not intended for routine contraception
  • May cause nausea, fatigue, irregular bleeding

Commonly Confused Concepts

Contraceptive Method Comparison

MethodEffectivenessKey Nursing Consideration
Combined OCP99% perfect useSame time daily, ACHES symptoms
Progestin-only99% perfect use3-hour window, safe breastfeeding
Depo-Provera99%Bone density, delayed fertility
IUD99%Infection screening, cramping normal

Common Pitfalls

  • Forgetting that progestin-only pills have stricter timing requirements
  • Missing that Depo-Provera can delay return to fertility
  • Not recognizing that emergency contraception prevents pregnancy, doesn't terminate it

Study Tips and Self-Assessment

Study Strategy

Create flashcards linking each contraceptive method to its key nursing considerations, contraindications, and patient teaching points. Focus on timing requirements and warning signs.

Quick Check Questions

  • ☐ Can you identify ACHES warning signs for combined oral contraceptives?
  • ☐ Do you know the timing window for progestin-only pills?
  • ☐ Can you explain why Depo-Provera affects bone density?
  • ☐ Do you understand the difference between copper and hormonal IUDs?
  • ☐ Can you counsel patients on emergency contraception timing?

Remember: Patient education and safety are paramount in contraceptive counseling. You've got this - focus on understanding the mechanisms and nursing implications for each method!

다음 이론을 계속 학습하려면 로그인하세요.

로그인하고 계속 학습
컨텐츠를 그만볼래?

필기노트, 하이라이터, 메모는 잘 쓰고 있어?

내보내줘
어떤 폴더에 저장할래?

컨텐츠 노트에는 총 0개의 폴더가 있어!

폴더 만들기
컨텐츠 만들기
만들기
신고했어요.

운영진이 검토할게요!

해당 유저를 차단했어요.

마이페이지에서 차단한 회원을 관리할 수 있어요.