Ascertaining Type of Birth Control for Maria
While ascertaining the best birth control method fit for Maria, it is important to ensure that I inquire more on her health status, family health history, occupation, and contraceptive type. Some of the questions that I will ask will seek to understand Maria’s health factors that might limit the use of various contraceptives. I will also ask for her moral and religious values to ensure that the chosen method will fit her. I will inform Maria about various birth control methods based on various elements, including acceptability, availability (affordability and accessibility), effectiveness, and safety (CDC, 2022). I will also ensure that Maria understands the difference between typical and perfect use of birth control. With perfect use, the method of contraceptive ability is measured by correct use as consistent, while typical use refers to the ability of the birth control method to protect Maria from becoming pregnant without being monitored.
Birth Control Pills
After discussing with Maria, she chooses birth control pills as her fit control method. Oral contraceptive pills are more effective, the most commonly used method. However, for the birth control pills to work effectively, I will provide Maria with more information about the pills. If the patient chooses to use both the progesterone and ethinylestradiol pill, I will advise her to omit the monthly withdrawal bleed to reduce pills’ symptoms and increase efficiency (Messenger, 2019). The combine’s oral contraceptives are not strict regarding regular dosing, which makes it fit for her lifestyle as a nurse. I will advise Maria to start her contraceptive park five days after the beginning of her period, protecting her against pregnancy right away. Maria should expect some side effects, including bloating, nausea, headache, elevated blood pressure, breasts tenderness, bleeding, or spotting. If Maria experiences worsening headaches, fainting, eye problems, chest pain, breasts lump, or abdominal pain, she should see the doctor as soon as possible.
Birth Control Alternative for Maria
Maria is having difficulties remembering to take the pills making the method ineffective, and she wants between the vaginal ring and patch. First, I would like to inform her that both methods are hormonal with progestin and estrogen (Graffin, 2019). A patch is an adhesive, thin and small square applied to the skin while the ring is light and flexible and is inserted in the vagina. Vaginal rings cause discharge and vaginal irritation, while patch causes vomiting, nausea, painful periods, and breast discomfort.
Difference between IUD and Implant (Nexplaton)
IUD and nexplanon are long-term birth control options that Maria can choose. The IUD prevents pregnancy for at least seven years, while nexplaton is implanted in the skin for the preferred period (Brunie et al., 2021). Both methods thicken the cervical mucus and suppress ovulation. Nexplaton’s side effects include depression, mood change, cramping, breast tenderness, acne, weight gain, vaginitis, menstrual changes, and headaches. Mirena causes irregular bleeding patterns, abdominal cramping, vaginal discharge, inflammation, and headache.
Maria’s Symptoms after IUD Placement
Although IUDs are effective in preventing pregnancy, they also have side effects. After the IUD is inserted into the body, the body detects a foreign object, and it might even irritate sensitive tissues (Brunie et al., 2021). As a result, it might also cause smelly and watery discharge showing a sign of an infection. Hoverer I will prescribe some antibiotics for the patient to treat the infection without removing IUD to assess for improvements.
Birth control Method for Patients with Hypertension
If the patient has hypertension, I recommend she use other options other than birth control pills. This is because if a patient has high blood pressure, they should avoid using estrogen contraceptives since it increases blood pressure (Messenger, 2019). Using the pills could also increase the client’s heart attack and stroke risk. Therefore, I would recommend the patient take a hormonal IUD or an implant that has progesterone only.
How to Manage Maria Based On Her Family Health Background
Based on the information provided, Maria may have a factor V Leiden mutation in case she has a DNA mutation in her genes since her mother has it, and it was discovered after DVT development (Morimont et al., 2021). I would therefore advise Maria to avoid oral pills due to her heightened risk for venous thromboembolism.
References
Brunie, A., Stankevitz, K., Nwala, A. A., Nqumayo, M., Chen, M., Danna, K., … & Rademacher, K. H. (2021). Expanding long-acting contraceptive options: a prospective cohort study of the hormonal intrauterine device, copper intrauterine device, and implants in Nigeria and Zambia. The Lancet Global Health, 9(10), e1431-e1441. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00318-1/fulltext
Centre for Disease Control and Prevention (CDC). (2022). Contraception. https://www.cdc.gov/reproductivehealth/contraception/index.htm
Griffin, J. B., Ridgeway, K., Montgomery, E., Torjesen, K., Clark, R., Peterson, J., Baggaley, R., & van der Straten, A. (2019). Vaginal ring acceptability and related preferences among women in low- and middle-income countries: A systematic review and narrative synthesis. PloS one, 14(11), e0224898. https://doi.org/10.1371/journal.pone.0224898
Messsenger, B. (2019). Oral contraceptives: selecting a pill. BPAC, 1-10. https://bpac.org.nz/2021/contraception/docs/oral-contraceptives.pdf
Morimont, L., Haguet, H., Dogné, J. M., Gaspard, U., & Douxfils, J. (2021). Combined Oral Contraceptives and Venous Thromboembolism: Review and Perspective to Mitigate the Risk. Frontiers in endocrinology, 12. https://www.frontiersin.org/articles/10.3389/fendo.2021.769187/full
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