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Discussion: Claudia, Age 26 Come to the Nurse Practitioner

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Claudia is a 26-year-old mother of two G2P2, she recently delivered her last child 9 months ago, and has been using condoms for birth control for the last 7 months. Today she is requesting a more reliable birth control, she is not sure of her current pregnancy plans, however, she does not wish to discuss sterilization. No religious contraindications for treatment. Previous methods include condoms, and oral contraceptive pills.

  • PMH: positive for mild hypertension with first pregnancy, seasonal allergies.
  • Surgeries: Right inguinal hernia and tonsillectomy.
  • Family history: Mother HTN and Father colon CA both living
  • 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, prn Allegra for allergies. Height 65 inches, weight 137 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?
  2. What are two possible contraceptive methods for Claudia? Please give brief rationale for each.
  3. Pick one method and list five (5) patient-centered teaching points for the method you chose today.
  4. What would your contraceptive choice be if Claudia smoked 10-15 cigarettes per day? Explain your answer.

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