Given the above situation, what contraceptive options are there available for her?
Margaret provided a lot of great information to be able to develop a correct treatment
plan regarding her contraceptive option. According to the findings of the physical exam,
Margaret was found to be going through the stress of separation and considering divorce, she has
picked up smoking as a habit as well as not eating well leading to her gaining weight. Margaret
also has a significant family history of cardiovascular disease, diabetes and hypertension. When
considering the best form of contraception for the patient all aspects of health, current lifestyle
and patient’s personal and family health history should be taken into account (Prior, 2017). It
would also be important to discuss with Margaret about needing to now decide if the form of
contraception that is chosen would also protect her from sexually transmitted infections as she
was no longer in a monogamous relationship with her husband (Prior, 2017)
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).
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
Margaret provided a lot of great information to be able to develop a correct treatment
plan regarding her contraceptive option. According to the findings of the physical exam,
Margaret was found to be going through the stress of separation and considering divorce, she has
picked up smoking as a habit as well as not eating well leading to her gaining weight. Margaret
also has a significant family history of cardiovascular disease, diabetes and hypertension. When
considering the best form of contraception for the patient all aspects of health, current lifestyle
and patient’s personal and family health history should be taken into account (Prior, 2017). It
would also be important to discuss with Margaret about needing to now decide if the form of
contraception that is chosen would also protect her from sexually transmitted infections as she
was no longer in a monogamous relationship with her husband (Prior, 2017)
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).
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
