NSG6005 Advanced Pharmacology FL02 Week 8 Completed A

NSG6005 Advanced Pharmacology FL02 Week 8 What options are appropriate for this patient? After considering the information provided in the clinic visit, Margaret does have some options she can consider for contraception. Some of the options she can choose from would be a barrier method utilizing condoms, diaphragms, spermicides, and cervical sponges, but would need to be educated on ensuring safer sex practices (Prior, 2017). Other options include progestin only contraceptives, an intrauterine device or to consider surgical or hysteroscopic sterilization (Prior, 2017). Regardless of the decision made by the patient, as a healthcare provider, we should provide all the options in a non-judgmental and supportive approach allowing the patient to ultimately choose the best option that they will continue to follow past the appointment that will able to be a part of their regular lifestyle (Prior, 2017). What options are contraindicated, and why? Due to Margaret’s physical assessment, she does have some red flags that would prevent all contraception methods to be an option. Margaret is 40, is currently smoking and oral contraceptives that contain both estrogen and progestin which is not recommended for women over the age of 35 as well as should be used in caution in women who smoke, have hypertension with a BP of greater than 140/90 mm Hg, have been diagnosed with diabetes mellitus, hyperlipidemia, have a history or have been diagnosed with deep vein thrombosis or pulmonary embolus and those who have a history of stroke or coronary artery disease (Gerly, 2015). Additionally, Margaret’s history is pretty extensive and includes some of these criteria which would make an estrogen oral contraceptive a poor choice for contraception options. What type of patient education is indicated? Margaret would need some education on the type of contraception that she decides to use, but she also has some major education that needs to be included regarding her lifestyle choices. Margaret has picked up smoking as a means to manage her stress as well as gained weight from poor food choices, discussing exercise as a means to burn stress would allow her to manage her weight as well as stress. The different types of contraception would also require some education depending on which type Margaret chose. If Margaret were to choose barrier methods of contraception, providing education on the proper way to apply to would be vital to the correct use (Prior, 2017). Intrauterine devices do not require as much education for application as it is done in the clinic setting, but patients should know to check for the IUD string for proper placement as well as signs and symptoms of the IUD becoming displaced including pain, bleeding, discharge and fever. A patient should also be aware of the possibility for their menstrual cycle to become irregular or stop (Prior, 2017). If Progestin only pills were chosen as her contraception of choice, Margaret would need to be educated on the possibility of weight gain, menstrual cycle disruption and a possibly increase in both ovarian cysts and ectopic pregnancy (Prior, 2017). Education would also be important regarding emergency contraception in the instance Margaret needs to utilize this option. It is not advisable to use this as one’s only form of birth control and should be taken within 3 days of unprotected sex or the effectiveness decreases (Prior, 2017). Some potential side effects for oral contraceptives include severe abdominal pain, chest pain and feeling short of breath, dizziness and headaches with some issues involving speech as well as severe leg pain (Prior, 2017). These are all serious symptoms that need to be addressed with one’s healthcare provider or emergency medicine as they can be beginning symptoms of stroke, deep vein thrombosis or pulmonary embolism. Given that she has a normal pelvic exam, does that change would that influence your decision? It's a good idea to ensure a pelvic exam is done to rule out pelvic or abdominal pain, to check for abnormal vaginal discharge or abnormal bleeding and if the patient has sexually transmitted disease (STD). References: Gerly, T, (2015). Contraception. In T. M. Woo & M. V. Robinson (Eds). Pharmacotherapeutics for advance practice nurse prescribers, 4th Edition. (pp. 943-956). Retrieved from: Prior, R. M. (2017). Fertility control. In T. M. Buttaro, J. A. Trybulski, P. Polgar-Bailey, & J. Sandberg-Cook (Eds). Primary care: A collaborative practice 5th Edition (pp. 831- 837). Retrieved from: