Answer

Contraceptive-Case Study

Additional History

Birth control methods have become a common topic in the current world, with many people becoming aware of their economic state. However, there is information that one requires to determine the type and the way forward for any birth control options. In Casey’s case, besides the number of sexual partners, types of birth control measures, the frequency at which she has sex, and her body’s state, religious information is essential in ensuring that the birth control measures are not against her convictions. Also, socioeconomic characteristics are considered when deciding on birth control options (Tsikouras et al., 2018). Considering all the options ensures that the client is comfortable using the chosen birth control method. 

Since Casey takes drugs like alcohol and marijuana not medically prescribed, checking on her mental status and any effects of the drugs on her body would also play a vital role in determining the birth control option. Asking Casey about the period she has used alcohol and marijuana is essential. Terplan et al. (2016) mention that women struggling with substance use disorders tend to fall victims to unintended pregnancies, requiring a long-lasting birth control measure to cover for forgetfulness. A proper assessment establishes the effect the drugs have on Casey for a better judgment. In Casey’s case, her inconsistency in using birth control methods before sexual intercourse might influence her prolonged use of drugs and substance abuse.

Assessment and Lab Requirements

Before suggesting a birth control option to Casey, nurses should ensure that they receive the necessary assessments and lab reports for the correct prescription. Before administering any hormonal contraceptive, pharmacists need to acquire the patient’s appropriate medication and medical proven history and assess pregnancy status, including the patients’ menstrual cycle (Mobarak et al., 2019). Also, running a lab report on the patient’s blood pressure is critical to determine whether the patient is legible for the contraceptives or should visit a physician for further evaluation. The information is vital to curb any further damages to the patient in case they have underlying conditions. Considering that Casey uses drugs and forgets to use protection, she may have underlying conditions leading to blood pressure or pregnancy.

Pharmacists should adhere to all the ethical considerations and follow procedures to prevent hormonal contraceptives from reacting negatively with the patient causing severe health conditions. From the study, pharmacists need to screen for any supplement use and medication that would overrule drug-drug interactivity with some medicines like antibiotics, precisely, anticonvulsants (Mobarak et al., 2019). Determining such factors would save the patient from suffering severe complications and prevent the contraceptive from working effectively. In Casey’s case, she uses un-prescribed substances that may react with the hormonal contraceptive leading to its ineffectiveness. Pharmacists must assess the patient, record all the necessary information, and supplement lab reports to ascertain the patient’s options for birth control options.

Suitable and Unsuitable Contraceptive Methods

Pharmacists need to establish the best contraceptive that suits Casey with minimal or no side effects with all variables considered. For women with substance use disorders, implants and Intrauterine Device, commonly called the Long-Acting Reversible Contraception (LARC), are most suitable (Black & Day, 2016). Although they do not prevent Sexually Transmitted Infections (STIs), using LARC eliminates the inconsistencies typical with oral contraceptive pills since they are a set-and-forget option, offering a long-lasting solution for unintended pregnancy. The methods are most efficient for a patient like Casey since she is prone to forgetting. Since she has not reacted to past birth control methods, Casey is less likely to react to LARC, which has bleeding as one of its side effects. Moreover, since Casey is not financially stable, LARC is appropriate as it is cost-effective, unlike oral contraceptive pills and condoms, which require money for use.

The sexual status of the patent stands as a determinant factor in determining the type of contraceptive to administer. Casey appears to be sexually active, considering that she has had sexual contact with three men in two years. Besides, her use of alcohol and marijuana impairs her judgment, making her forget to use them before and after sex contraceptives. Therefore, Casey is not fit to use the daily intake contraceptives. Contraceptive usage among women invites stigma and fear of experience due to infertility misconception (Black & Day, 2016). As a young girl, Casey might shy away from constantly taking pills or seen with condoms; hence may not adhere to the prescription instructions making IUD the most preferred method of birth control.

Information on Preferred Contraceptives

Casey’s underlying conditions call for the utilization of LARCs, which come in two ways, Intrauterine Device (IUDs) and the drug or hormonal-eluting subdermal implants. Sierra (2019) discusses in length the information for each of the above contraceptives. IUDs exist in five forms, four of which are hormonal, and one is non-hormonal. Casey is most legible for the Liletta IUD since it is a long effective period of four years, and it also acts against pain during insertion. Moreover, the device is affordable and available for women like Casey, who may not have insurance cover. This device’s side effects are minimal, highlighting a one-year deficit against Mirena, which is effective for five years. However, the benefits appear to overwhelm the cons; hence the patient is likely to benefit from this IUD device.

Subdermal implants are another contraceptive suitable for Casey. Etonogestrel subdermal is readily available, and its effectiveness lasts up to three years. The implant has the highest percentage of significance when the insertion procedure is carefully followed. Clinicians are advised to get training on the one-hand insertion procedure since there are chances of the implant falling. Despite the benefits of not undergoing numerous checks before insertion like IUDs and its elevation of endometriosis-related dysmenorrhea, etonogestrel subdermal has its shortcomings. The patient would experience irregular menstrual cycles that are less predictable than those for women using IUDs. Along with that, she is likely to gain more weight, experience pain, and develop vaginal cysts (Sierra, 2019). Moreover, this implant is more difficult to remove compared to IUDs. Therefore, liletta happens to be the preferable option of birth control for Casey.

Additional Education

As a teenager, Casey is entitled to all the necessary information concerning contraceptives and the possible side effects, especially since she is under drug and substance use. Clinicians should let Casey know of all the available options, their advantages, disadvantages, and most preferred methods and be given a chance to choose a preferred method that she feels would be suitable. Since IUD is most preferred, Casey is advised to follow up checkup placement (Sierra, 2019). Contraceptive education is essential to let the patient know the magnitude of their decision and the underlying effects.

During counseling, providing a remedy for some of the side effects, especially for subdermal implants, is essential. Advising the patient to reduce alcohol and marijuana intake would help her gain more control of her body. Also, eating healthy foods and engaging in physical exercise would regulate her hormones and control weight gains. Letting the patient know that the birth control method is legible for removal in case of any severe discomforts and unusual health changes is also an important measure. Therefore, the patient must gain as much information about the contraceptive measure to act accordingly when any notable changes occur.