Claudia (G2P2) is a 36-year-old mother who recently delivered a child 9 months ago. She has been using condoms for
birth control for the last 7 months. Today she is requesting a more convenient method of birth control. She is not sure of
her current pregnancy plans, However, she does not wish to discuss sterilization or an IUD. She has no religious
contraindications for treatment.
PMH: positive for mild hypertension with first pregnancy, seasonal allergies.
Surgeries: Left inguinal hernia and tonsillectomy.
Family history: Mother-HTN; Father-Colon CA (both deceased)
Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week.
Drug allergies-Sulfa causes a rash.
Current medications-MVI with Fe, Calcium chews, Allegra 10mg daily prn for allergies.
Vitals: Height 67 inches, weight 157 pounds, BP 110/75, P 70, R 16. PAP collected today, breast exam WNL, urine
pregnancy negative.
Physical exam is normal.
Dr. Chen and classmates,
What are your treatment goals for Claudia today?
A treatment goal today is to provide Claudia with safe, highly effective contraceptive options that fit with her lifestyle in
order to provide the highest likelihood of compliance possible. Given that she is a new mother to a 9 month old, I would
include recommending a pharmacological method that does not require daily administration. Another treatment goal is
to ensure that she understands the administration schedule, associated risks, potential side effects, and impact on
future pregnancies.
1.What are two possible medications (in different classes) that you can recommend for Claudia? Please provide detailed
rationale and mechanism of actions for each medication. Make sure that all recommendations are cited with guidelines
or scholarly, peer-reviewed articles and always include medication, strength, dosage form, route, frequency and
duration when making recommendations.
I would recommend a flexible vaginal ring if the patient was not interested in a daily oral contraceptive. The brand name
NuvaRing delivers 0.120 mg etonogestrel/0.015mg ethinyl estradiol vaginal ring per day. The ring is inserted into the
vagina and left in place for 3 weeks, removed for 1 week, and then a new ring is inserted (Ethinyl Estradiol and
Etonogestrel Vaginal Ring, 2019). Tis method of birthcontrol is a combined oral contraceptive. It works by preventing
ovulation and changing the lining of the uterus so that sperm does not enter the cervix.
2. Pick of the medications from your response above and list five (5) patient-centered teaching points to communicate
to the patient.
In educating Claudia regarding the vaginal ring I would include the following (Ethinyl Estradiol and Etonogestrel Vaginal
Ring, 2019):
This study source was downloaded by 100000830246019 from CourseHero.com on 06-10-2022 06:16:56 GMT -05:00
https://www.coursehero.com/file/49202692/NR508-D2-Contraceptive-Rxpdf/
birth control for the last 7 months. Today she is requesting a more convenient method of birth control. She is not sure of
her current pregnancy plans, However, she does not wish to discuss sterilization or an IUD. She has no religious
contraindications for treatment.
PMH: positive for mild hypertension with first pregnancy, seasonal allergies.
Surgeries: Left inguinal hernia and tonsillectomy.
Family history: Mother-HTN; Father-Colon CA (both deceased)
Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week.
Drug allergies-Sulfa causes a rash.
Current medications-MVI with Fe, Calcium chews, Allegra 10mg daily prn for allergies.
Vitals: Height 67 inches, weight 157 pounds, BP 110/75, P 70, R 16. PAP collected today, breast exam WNL, urine
pregnancy negative.
Physical exam is normal.
Dr. Chen and classmates,
What are your treatment goals for Claudia today?
A treatment goal today is to provide Claudia with safe, highly effective contraceptive options that fit with her lifestyle in
order to provide the highest likelihood of compliance possible. Given that she is a new mother to a 9 month old, I would
include recommending a pharmacological method that does not require daily administration. Another treatment goal is
to ensure that she understands the administration schedule, associated risks, potential side effects, and impact on
future pregnancies.
1.What are two possible medications (in different classes) that you can recommend for Claudia? Please provide detailed
rationale and mechanism of actions for each medication. Make sure that all recommendations are cited with guidelines
or scholarly, peer-reviewed articles and always include medication, strength, dosage form, route, frequency and
duration when making recommendations.
I would recommend a flexible vaginal ring if the patient was not interested in a daily oral contraceptive. The brand name
NuvaRing delivers 0.120 mg etonogestrel/0.015mg ethinyl estradiol vaginal ring per day. The ring is inserted into the
vagina and left in place for 3 weeks, removed for 1 week, and then a new ring is inserted (Ethinyl Estradiol and
Etonogestrel Vaginal Ring, 2019). Tis method of birthcontrol is a combined oral contraceptive. It works by preventing
ovulation and changing the lining of the uterus so that sperm does not enter the cervix.
2. Pick of the medications from your response above and list five (5) patient-centered teaching points to communicate
to the patient.
In educating Claudia regarding the vaginal ring I would include the following (Ethinyl Estradiol and Etonogestrel Vaginal
Ring, 2019):
This study source was downloaded by 100000830246019 from CourseHero.com on 06-10-2022 06:16:56 GMT -05:00
https://www.coursehero.com/file/49202692/NR508-D2-Contraceptive-Rxpdf/
