Considering the potentially negative consequences of unintended pregnancy for a woman’s health and well-being, effective contraceptive treatments are an important part of gynecologic care. There are a variety of contraceptive treatment methods available for women, including hormonal, barrier, and fertility awareness options. Each method has its own strengths and limitations, and each patient often has individual factors that might also impact appropriateness of use. In your role as the advanced practice nurse, it is important to keep in mind that while you may make contraceptive recommendations to patients, contraceptive selection is a joint decision between the patient and the provider. For this Discussion, consider which contraceptive treatments would be most appropriate for the patients in the following three case studies:
Case Study 1:
A 23-year-old Caucasian female presents with concerns about mood swings around the time of her menses. She believes she has PMS and wants to know if there is medication to control it.
Case Study 2:
A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time. She has never been pregnant and she has one male sex partner. Her gynecologic exam is normal.
Case Study 3:
A 33-year-old Caucasian female is being seen in clinic for contraception. She is using birth control pills, but forgets to take them because her work schedule changes every week. She has been married for 14 years and has two children. She is looking for an effective method that will be easy to remember. She has a history of chronic headaches and hypertension during pregnancy. She has never been treated for a sexually transmitted infection and is in a mutually monogamous relationship. Family history is significant for an aunt with breast cancer. She smokes half a pack of cigarettes per day. She is 5 ft. 8 in. and 215 lbs. Her vital signs are: BP 120/78, p 72, reg.
Post on or before Day 3 an explanation of the contraception treatment that would be most appropriate for the patient in the case study you selected, and explain why. Explain how you might work with patients who do not agree with your recommendations.