Discussion 8 – Welfare of Women

1. L., a 27-year-old African-American female account executive, presents to the Family Medicine office for her annual checkup with her CNP. She has no significant past medical history. Her medications include calcium carbonate 500 mg orally twice a day and a multivitamin daily. She exercises regularly. Her family history is significant for cardiovascular disease (her father had an MI at age 54 and died of a further MI at age 63). She notes that she has been dating her current partner for approximately 5 months. She is interested in a reliable form of contraception. After discussing the various contraceptive options, she decides that an oral contraceptive (OC) would best fit her needs.Discussion 8 – Welfare of Women

In this discussion forum:

Discuss what tests or examinations the CNP would likely perform before prescribing an OC regimen, and why.

Discuss two different OC regimens that could be chosen for J. L. Discuss their differences and why you chose them.

Discuss the potential side effects of each OC regimen that need to be relayed to J. L. Discuss especially those effects for which she should seek immediate medical care.

Discuss health promotion recommendations you would consider for J. L.

What ethical issues should be considered?

Reproductive Case Study

1. L., a 27-year-old African-American female account executive, presents to the Family Medicine office for her annual checkup

with her CNP. She has no significant past medical history. Her medications include calcium carbonate 500 mg orally twice a day and a multivitamin daily. She exercises regularly. Her family history is significant for cardiovascular disease (her father had an MI at age 54 and died of a further MI at age 63). She notes that she has been dating her current partner for approximately 5 months. She is interested in a reliable form of contraception. After discussing the various contraceptive options, she decides that an oral contraceptive (OC) would best fit her needs.Discussion 8 – Welfare of Women

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Tests or examinations the CNP before prescribing an OC regimen, and why

A general examination would be crucial to ascertain reproductive health. A complete gynecological exam, including a pap smear, would also come in handy to evaluate J.her’s cervical health. I would also conduct an exhaustive physical examination, extending to blood pressure monitoring, body weight, and a pregnancy test, which L.are crucial ‘prior to clinical decision-making regarding contraception (Reinhold, 2016). Heart disease assessments encompassing baseline lab tests like cholesterol and triglycerides are also necessary. A diabetes check is also crucial since oral contraceptives present challenges with blood glucose level monitoring.

Two Different OC Regimens that could be Chosen for J. L. – Combined Agent Contraceptives vs Single Agent Contraceptives

Oral contraceptives are categorized into two: combined hormonal therapy and single-agent hormonal therapy. While the former combines estrogen and progestin hormones inhibiting LH and FSH release, the latter only uses progestin, thus shifting the uterine environment. Combined therapy holds back ovulation and is often 99% effective when taken accurately (Reinhold, 2016). On the other hand, single-agent contraceptives may require backup contraception since the effect reduces 22 hours following administration. Combined therapy reduces the risk of endometriosis, ovarian cysts, pain, breast disease, and premenstrual syndrome, among other conditions. Single-agent therapy provides an option for women at risk of hypertension and those who can barely tolerate medications containing high estrogen levels.

Potential Side Effects of Each OC Regimen

Research has established that all contraceptives have adverse effects, some of which may be life-threatening. J.L. should seek immediate medical attention in the event she experiences blood clots, heart attack, stroke, and/or lumps in the breast or liver for combined hormonal therapy (Römer, 2019). Single-agent contraceptives may result in acne, dizziness, headaches, and breast tenderness, which often do not require urgent medical attention.Discussion 8 – Welfare of Women

Health Promotion

Patient education is an essential aspect of wellness. With oral contraceptives, the healthcare provider must encourage J.L. to promote her health and wellness by quitting smoking, attending routine medical checkups, adopting an active rather than sedentary lifestyle, and practising safe sex (Römer, 2019).

Ethical Issues Associated with Oral Contraceptives

With contraception being a major ethical issue across the globe, oral contraceptives remain the most controversial contraception choice since inception. The ethical considerations perhaps arise from the convenience and popularity of the contraceptive pill. Some of the ethical concerns that have since been raised include religious restrictions, personal beliefs and morals surrounding the idea that life begins at conception, and the notion that oral contraceptives are an excuse for reckless sexual behaviors among the female population (Vergallo et al., 2017).

References

Reinhold, J. A. (2016). Pharmacotherapeutics for Advanced Practice-a Practical Approach. Lippincott Williams And Wilkin.

Römer, T. (2019). Medical eligibility for contraception in women at increased risk. Deutsches Ärzteblatt International, 116(45), 764.

Vergallo, G. M., Zaami, S., Di Luca, N. M., & Marinelli, E. (2017). The conscientious objection: debate on emergency contraception. Clin Ter, 168(2), e113-e119.Discussion 8 – Welfare of Women