Contraception

Case Study 1Case Study: ContraceptionScenario 1Elaine Goodwin is a 38-year-old G5 P5 LC 6?presenting to your clinic today to discuss contraceptive options.??She states that sheÿis notÿinterested in having more children?but her new partner has never fathered a child.?Her medical history is?remarkable for exercise-induced asthma, migraines, and IBS.?Her surgical history?is remarkable only for tonsils as a child. Her social history is negative for?alcohol, tobacco, and recreational drugs.? She has no known drug allergies and takes only vitamin C.?Hospitalizations were only for childbirth.?Family history?reveals that her maternal grandmother is alive with dementia, while her maternal grandfather is aliveÿwith COPD. Her paternal grandparents are both deceased?due to an automobile accident. Her mother is alive with osteopenia and fibromyalgia, and her dad is alive with a history of skin cancer (basal cell).?Elaine has one older sister with no medical problems and one younger brother with no reported medical problems.Height 5? 7??Weight?148?(BMI 23.1),?BP 118/72 P?68HEENT:?ÿwnlNeck: supple without adenopathyLungs/CV:ÿwnlBreast: soft, fibrocystic changes bilaterally,?without masses, dimpling or dischargeAbd: soft, +BS, no tendernessVVBSU:ÿwnl, except?1st?degree cystoceleCervix: firm, smooth, parous, without CMTUterus: RV, mobile,?non-tender,?approximately 10 cm,Adnexa: without masses or tendernessQUESTION:What other information do you need?MORE QUESTIONS:What has she used in the?past?? Why did she stop a?method?? How many partners in past 12?months?What are her current cycles like?When was her last gyn exam?and what were the resultsÿof?the?tests?Are her migraines with or without auras?What method has she considered.QUESTIONS:?What are your next steps/considerations??;What teaching should you do??What methods are appropriate for Elaine?