Discussion Post
July 10th, 2023
Review the case study and answer the following questions.
Case Study: A 16-year-old arrived at a local family planning clinic with pregnancy concerns due to unprotected intercourse. This encounter occurred two nights prior, and she believes she may be fertile but wants information regarding the “morning-after pill”.
- What additional information should the nurse obtain during the assessment?
- What educational information should the nurse provide to the patient regarding emergency contraception treatment and the side effects?
Answers
Additional information the nurse should obtain during the assessment:
- Menstrual history: The nurse should inquire about the patient’s last menstrual period to determine if she is within her fertile window or near the time of ovulation.
- Contraceptive history: The nurse should ask about the patient’s current contraceptive method, if any, and whether it was used correctly and consistently during the recent sexual encounter.
- Allergies: The nurse should ask about any known allergies or adverse reactions to medications, especially those commonly used in emergency contraception.
- Current medications: The nurse should inquire about any medications the patient is currently taking to check for potential drug interactions with emergency contraception.
- Medical history: The nurse should ask about any pre-existing medical conditions, especially any conditions that may contraindicate the use of emergency contraception.
- Sexual history: The nurse may want to explore the patient’s sexual history to assess for potential risks of sexually transmitted infections (STIs) and provide appropriate counseling and testing.
Educational information the nurse should provide regarding emergency contraception treatment and side effects:
- Explanation of emergency contraception: The nurse should explain what emergency contraception is and how it works to prevent pregnancy after unprotected intercourse or contraceptive failure.
- Time frame for effectiveness: The nurse should inform the patient that emergency contraception is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours (but some types can be taken up to 120 hours) to maximize its efficacy.
- Available options: The nurse should discuss the different types of emergency contraception available, such as the morning-after pill (which can be either a progestin-only pill or a combination of hormones) and the copper intrauterine device (IUD).
- Side effects: The nurse should explain the potential side effects of emergency contraception, which may include nausea, vomiting, abdominal pain, breast tenderness, fatigue, and changes in menstrual bleeding patterns. These side effects are usually temporary and should resolve within a few days.
- Effectiveness: The nurse should discuss the effectiveness of emergency contraception in preventing pregnancy. While it significantly reduces the risk of pregnancy, it is not 100% guaranteed, and the patient should be aware that if pregnancy occurs despite taking emergency contraception, she should seek further evaluation.
- Follow-up and regular contraception: The nurse should emphasize the importance of follow-up care, including scheduling a follow-up visit to ensure the patient’s well-being and discuss ongoing contraception options to prevent future unintended pregnancies.
- STI prevention: The nurse should provide education on the importance of STI prevention methods, such as condom use, to protect against both unintended pregnancy and sexually transmitted infections. The nurse may also discuss the option of STI testing if appropriate.
It’s important to note that this case study involves a hypothetical scenario, and the specific information and recommendations may vary based on the patient’s individual circumstances and healthcare provider guidelines.