Question

Combined Hormonal Contraceptives 1. What are the contraindications associated with the drug class you are responding to? 2. As a nurse, what nursing assessment will you be sure to do and why? 3. What patient teaching would you provide to the patient starting medication in the drug class you are responding to? Why would you give this teaching? 4. Compare differences between the Combined Hormonal Contraceptives and Progestin Contraceptives medication drug classes? (Examples but not limited to: Why would one be given over another? Are they given for the long term? Which are available in IV form? Which are available in a patch form? When would we give IV over PO?)

Answer 1

1.The main contraindication for the combine hormonal contraceptives are

• Increased age usually above 35 years older
• Medical conditions:Diabetes, Hypertension, SLE,cardiovascular disease ,anemia
• Others:smokers
• Lactating women ,breastfeeding mothers
• Hypersensitivity to the drug
• Miscarriage
• Adolescents
• Infectious diseases

2.The nursing assessment required to be done

• Assess and collect a thorough history of the patient, medical and surgical condition, lifestyle, smoking, age factor ,etc.,
• Know the clients last menstrual period
• Assess for any active pregnancy
• Knowledge level if the client
• Indication for prescription of thos drug

3.The following patient teach are required

• It is a birth control pill ,so planning for a baby with this medication is not an healthy option
• Do not skip the dose, otherwise it will be less effective
• Donot over dise as it can be dangerous
• Complete the specified period of course and will start menstruation after the completion of tablets
• May experience side effects like breast tenderness ,heaviness, nause, low desire to sexual activity, possible weight gains

4.

Combined hormonal contraceptives

Progestin contraceptives

Has both progesterone and estrogen It is highly effective in preventing conception It stops ovulation Effective against a lot of medical conditions like irregular periods, premenstrual syndrome, menorrhagia Cannot be indicated if patient has other medical conditions Not recommended while breastfeeding Weight gain, breast tenderness, bleeding can be a side effects Increase risk for other medical conditions Available as oral pills,patches and as vaginal rings

Has only progesterone hormone Chance of conception is still present It is also called as mini pill It does not stop ovulation It is safe to be used with other medical conditions Can be given during pregnancy Available as oral pills ,intrauterine device This is available as injection form

An IV has to be given once a month, no chance of missing dose,effective for months, whereas the oral pill has to be take daily ,not effective for months ,chance of missing dose is possible