Case Study: A 16-year-old arrived at a local family planning clinic with pregnancy concerns due to unprotected intercourse. This encounter occurred two nights prior, and she believes she may be fertile but wants information regarding the “morning-after pill”.
What additional information should the nurse obtain during the assessment?
What educational information should the nurse provide to the patient regarding emergency contraception treatment and the side effects?
ANSWER
In this case, the nurse needs to conduct a thorough assessment and provide essential education on emergency contraception (EC) treatment and its side effects. Here are the steps the nurse should take:
**Assessment:**
1. **Menstrual History:**
– Determine the date of the patient’s last menstrual period (LMP) to assess the potential risk of pregnancy. Knowing the timing of the unprotected intercourse relative to her menstrual cycle is crucial in determining the effectiveness of emergency contraception.
2. **Details of Unprotected Intercourse:**
– Gather information about the timing of the unprotected intercourse, including the exact date and time it occurred. This information will help determine the window of effectiveness for EC options.
3. **Medical History:**
– Inquire about any underlying medical conditions or allergies the patient may have. Some medical conditions or allergies may influence the choice of emergency contraception.
4. **Current Medications:**
– Ask if the patient is currently taking any medications, as certain medications may interact with EC drugs.
5. **Contraceptive History:**
– Assess the patient’s history of contraceptive use. This information can help identify any patterns of contraceptive failure or gaps in knowledge about contraception.
6. **Sexual History:**
– Discuss the patient’s sexual history to determine whether this is an isolated incident or part of a pattern of risk-taking behavior. This conversation can provide insights into the patient’s need for ongoing contraceptive counseling.
**Education on Emergency Contraception:**
1. **Explanation of EC Options:**
– Explain that there are different types of emergency contraception available, including oral EC pills and copper intrauterine devices (IUDs). Provide information on where and how the patient can access these options.
2. **Timing is Critical:**
– Emphasize the importance of taking EC as soon as possible after unprotected intercourse for maximum effectiveness. Different EC options have different time frames for effectiveness.
3. **Efficacy and Risks:**
– Discuss the efficacy rates of the chosen EC method and any potential risks or side effects associated with its use. For example, oral EC pills may cause nausea or vomiting.
4. **Contraceptive Counseling:**
– Provide information on regular contraception methods, including the benefits and importance of consistent and correct use. Offer counseling on contraceptive options that may be suitable for the patient’s needs and preferences.
5. **Safety and Follow-Up:**
– Highlight the importance of seeking medical attention if the patient experiences severe side effects or if there are concerns about the EC’s effectiveness. Provide contact information for follow-up questions or concerns.
6. **Additional Resources:**
– Offer information about local family planning clinics, healthcare providers, or sexual health organizations where the patient can receive ongoing contraceptive counseling and reproductive healthcare.
It’s crucial for the nurse to provide non-judgmental, patient-centered care, ensuring that the patient is well-informed and able to make decisions about their reproductive health based on their individual circumstances and preferences.