Question

Melissa is a 31-year-old, recently married female who presents to your office for an annual visit. She has three children ages 2, 5, and 8. Her new husband wants to wait at least a year before they try to have a child of their own. She has used combined oral contraceptives (COCs) for more than 10 years. Since the birth of her last child, she has been using COCs intermittently.

She finds it too difficult to remember to take the pills regularly and wants an easier method. Menses are regular, although her periods seem heavier than usual, and she gets more irritable when she is not taking the COCs. She rarely exercises and admits to smoking and drinking occasionally. She is overweight. She has no medical history.

What additional information do you need to obtain?

Discuss her options and provide evidence for your rationale. Include patient education in your discussion?

please answer these questions.

1. She finds it too difficult to remember to take the pills regularly and wants an easier method.

2. Menses are regular, although her periods seem heavier than usual, and she gets more irritable when she is not taking the COCs.

3. She rarely exercises and admits to smoking and drinking occasionally.

4. She is overweight. She has no medical history.

- What additional information do you need to obtain?

- Discuss her options and provide evidence for your rationale. Include patient education in your discussion?

Answer 1

TIPS TO REMEMBER YOUR MEDICATION

1)keep a list of all medication

take medication at the same time everyday

leave yourself notes-to help you remember .Post-it notes on your bathroom mirror or anywhere according to your convenience

use a pillbox-with days of the week and keep your pillbox in a visible place,suchas kitchen table,and away from moisture,heat , light as well as children and pets

keep a calender-to write down doses and when refills are due

set an alarm -to remind when to take pills

Turn medication bottle upside down- after you take pills ,then turn it upright at the end of the day as a reminder to start fresh tomorrow

QUESTION2

continuous oral contraceptives can reduce total number of bleeding days women experience

QUESTION3

REGULAR EXERCISE can improve muscle strength and boost endurance.exercise deliver oxygen and nutrients to your tissuesand helps cardiovascular system work more efficiently.when heart and lung health improve ,we get more energy to tackle daily chores.Smoking leads to disease and disability and harms nearly every organ of the body .If alcohol is above the healthy level it can damage health

question 4

weight gain is a common concern for many people who take hormonal forms of birth control.it is mainly because of water retension. eventhough some believe it is not related to birth control pills

need  additional information about her dietery habits.

Whether she has the habit of sitting for large segments of the day?

Are you consuming large amount of calories in your daily diet?

Whether you have asked your doctor to conduct physical assessment and metabolic blood work?

Do you have any plan to change your birth control pills?

Patient education- Educate the patient about the importance of avoiding alcohol and smoke.

Educate the patient about the importance of regular exercise

Educate the patient that changes in routine such as sitting of large segments of day can leads to weight gane becuse it prevents calorie burn.

Changes in diet-Changes in diet can loose some weight for eg.Practicing low calorie healthy diet.

Do all physical assessment and check thyroid hormone.

Change birth control pills only according to doctors prescription because weight gain occur as a temporary side effect of fluid retention due to birth control pills.