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.
1. What are your treatment goals for Claudia today?
My treatment recommendation for Claudia is to discuss the various forms of birth control she
could utilize and to evaluate their effectiveness as well as ease of use for her to consider all of
her options. Patients may have misconceptions about contraceptives which is why education is
key (Philiberm Hirshm Brindis, Turner, and Philiber, 2017). The key to providing adequate
treatment is to have a clear understanding of her needs and wants. One thing that I would like to
understand is whether or not Claudia is still breastfeeding as this can affect her choice of
contraception. If she is strictly breastfeeding, progestin-only oral contraceptives may be
considered versus combined estrogen/progestin hormonal contraceptives (Curtis, Jatlaou, Tepper,
Zapta, Horton, Jameison, & Whiteman, 2016).
Due to her history of oral contraceptive use, this would be considered one form of treatment.
What would be discussed is whether or not she complied with the treatment regimen correctly
and whether she would like to continue treatment or not. To begin oral contraceptive use without
any contraindication we need to consider Claudia’s urine pregnancy test. Since Claudia’s initial
urine pregnancy test was negative, the use of oral contraceptives would be initiated and a repeat
urine pregnancy test would be needed. A follow-up pregnancy test should be performed within 2
to 4 weeks as there is a time frame where a negative test may be positive, which is a 2 week time
frame (Sullender et al, 2017). To determine that Claudia is not pregnant before contraception
insertion further assessment of questioning would need to be completed. The CDC provides
guidelines for questioning to ensure that woman is not pregnant within reason before
contraception use (Sullender et al, 2017). Before the use of contraception, the healthcare provider
This study source was downloaded by 100000830246019 from CourseHero.com on 06-10-2022 06:21:31 GMT -05:00
https://www.coursehero.com/file/54001389/Week-2-discussiondocx/
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.
1. What are your treatment goals for Claudia today?
My treatment recommendation for Claudia is to discuss the various forms of birth control she
could utilize and to evaluate their effectiveness as well as ease of use for her to consider all of
her options. Patients may have misconceptions about contraceptives which is why education is
key (Philiberm Hirshm Brindis, Turner, and Philiber, 2017). The key to providing adequate
treatment is to have a clear understanding of her needs and wants. One thing that I would like to
understand is whether or not Claudia is still breastfeeding as this can affect her choice of
contraception. If she is strictly breastfeeding, progestin-only oral contraceptives may be
considered versus combined estrogen/progestin hormonal contraceptives (Curtis, Jatlaou, Tepper,
Zapta, Horton, Jameison, & Whiteman, 2016).
Due to her history of oral contraceptive use, this would be considered one form of treatment.
What would be discussed is whether or not she complied with the treatment regimen correctly
and whether she would like to continue treatment or not. To begin oral contraceptive use without
any contraindication we need to consider Claudia’s urine pregnancy test. Since Claudia’s initial
urine pregnancy test was negative, the use of oral contraceptives would be initiated and a repeat
urine pregnancy test would be needed. A follow-up pregnancy test should be performed within 2
to 4 weeks as there is a time frame where a negative test may be positive, which is a 2 week time
frame (Sullender et al, 2017). To determine that Claudia is not pregnant before contraception
insertion further assessment of questioning would need to be completed. The CDC provides
guidelines for questioning to ensure that woman is not pregnant within reason before
contraception use (Sullender et al, 2017). Before the use of contraception, the healthcare provider
This study source was downloaded by 100000830246019 from CourseHero.com on 06-10-2022 06:21:31 GMT -05:00
https://www.coursehero.com/file/54001389/Week-2-discussiondocx/
