Women’s Health Disorders



Women’s Health Disorders





Scenario


K.W. is an 18-year-old woman who comes to Planned Parenthood for a pregnancy test because a condom broke during intercourse the night before. Her last menstrual period (LMP) was 13 days ago and was normal. She always has a monthly menstrual cycle. She is extremely nervous about pregnancy because she is beginning college on a scholarship soon. She states there have been no other acts of unprotected intercourse since her LMP. She did take oral contraceptives briefly in the past but discontinued use because of weight gain and mood swings.




Case Study Progress


There are three emergency contraceptive (EC) options: Plan B and ella, contraceptive pills containing estrogen and progesterone, and the copper intrauterine device (IUD).





Scenario


L.W., a 20-year-old college student, comes to the university health clinic for a pregnancy test. She has been sexually active with her boyfriend of 6 months, and her menstrual period is now 2 weeks late. The pregnancy test is positive. The patient begins to cry, saying, “I don’t know what to do.”



1. How will you begin to counsel L.W.?


2. What options does a woman experiencing an unplanned pregnancy have?


3. If your role is to assist her in making a choice, what information will you want L.W. to provide?


4. What are the nurse’s moral and ethical obligations in this situation?


5. L.W. asks you to tell her about abortion. What will you tell her?


6. L.W. wants you to explain the difference between vacuum aspiration and medical abortion. How would you explain this to her?


7. She tells you that she has heard that if a woman has an abortion, she might not be able to get pregnant again. How would you counsel her?


8. What types of emotional reactions do women experience after an abortion?


9. L.W. wants to know about adoption. What will you tell her?


10. L.W. asks you if there are any actions she should be doing now to take care of herself. How will you respond?


11. What factors affect carrying a pregnancy to term? L.W. asks you about the importance of prenatal care. Explain.


12. Finally, L.W. wants to know how long she has to decide.




Scenario


You are working in a busy OB/GYN office, and the last patient of the day is P.B., a 36-year-old who is planning to get married soon. She wants to use birth control but is not sure what to choose. Her fiancé is in law school, and they do not have health insurance, so she is anxious not to get pregnant right away. She asks you to review the various methods and help her explore what is best for her.



1. What past medical information will you need to ask P.B. about?


2. Are there any other conditions that would influence the choice of a contraceptive method?


3. Is P.B. currently at risk for sexually transmitted infections (STIs)?


4. What lifestyle information will help you assist P.B. in choosing an appropriate method for her?


5. P.B. asks you about the effectiveness rating of available birth control methods. Categorize your response according to the following efficacy ratings: most effective (more than 99%), highly effective (97% to 99%), and moderately effective (less than 90%).


6. P.B. asks you to explain the main advantages and disadvantages of the most effective methods.


7. What are the main advantages and disadvantages of the contraceptive methods in the highly effective category?


8. What about the moderately effective birth control methods? What are the main advantages and disadvantages?


9. She wants to know about cost with each method because she will be on a tight budget, with limited insurance coverage.


10. She asks you which method you would pick. What do you tell her?



Case Study Progress


P.B. comes back in a week and tells you that she can get a low-cost oral contraceptive through a local store. You convey this information to the nurse practitioner, who examines P.B. and writes a prescription for a biphasic pill containing ethinyl estradiol and norethindrone. You are asked to discuss the use of the pill with P.B.



11. What key factors should you address with P.B.?


12. A few months later, K.B. calls the clinic because she realized she missed a dose of her oral contraceptive. What will you tell her? (Select all that apply.)


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Jan 16, 2017 | Posted by in NURSING | Comments Off on Women’s Health Disorders

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