Which statement by a client taking oral contraceptives requires ...

[Kikoku]

Which statement by a client taking oral contraceptives requires immediate intervention by the nurse?
 
  1. I have started attending a smoking-cessation program.
  2. I forgot to take my pill twice last month, and I haven't started my period yet.
  3. I am only drinking one cup of coffee a day since I started taking birth control pills.
  4. I don't take those last seven pills at the end of my pill pack.

Question 2

A client has decided to terminate a pregnancy using medication. Which medication would not be effective if used for this purpose?
 
  1. Carboprost (Hemabate)
  2. Mifepristone (RU-486)
  3. Misoprostol (Cytotec)
  4. Levonorgestrel (Plan B)

[kmb352]

Answer to Question 1

Correct Answer: 2
Rationale 1: The client is attempting to stop smoking because smoking increases the risk of thromboembolic events.
Rationale 2: Missing the pill twice last month decreases the effectiveness of the contraceptive. The lack of a regular period could indicate pregnancy. The client needs a pregnancy test immediately, because oral contraceptives are pregnancy category X.
Rationale 3: The client is decreasing caffeine intake, which is recommended.
Rationale 4: The last seven pills are placebos and do not need to be taken if the client is able to remember when to start a new pack of pills.
Global Rationale: Missing the pill twice last month decreases the effectiveness of the contraceptive. The lack of a regular period could indicate pregnancy. The client needs a pregnancy test immediately, because oral contraceptives are pregnancy category X. The client is attempting to stop smoking because smoking increases the risk of thromboembolic events. The client is decreasing caffeine intake, which is recommended. The last seven pills are placebos and do not need to be taken if the client is able to remember when to start a new pack of pills.

Answer to Question 2

Correct Answer: 4
Rationale 1: Carboprost is a prostaglandin that can be used to induce uterine contractions that can expel an implanted embryo and result in abortion up to the second trimester.
Rationale 2: Mifepristone is an abortifacient and is used to induce abortions in pregnancies of less than 9 weeks' gestation.
Rationale 3: Misoprostol is given with mifepristone for early abortions, or alone to induce uterine contractions in a second-trimester abortion.
Rationale 4: Levonorgestrel (Plan B) is intended for emergency contraception, and will not cause termination of a pregnancy that is already in place.
Global Rationale: Carboprost is a prostaglandin that can be used to induce uterine contractions that can expel an implanted embryo and result in abortion up to the second trimester. Mifepristone is an abortifacient and is used to induce abortions in pregnancies of less than 9 weeks' gestation. Misoprostol is given with mifepristone for early abortions, or alone to induce uterine contractions in a second-trimester abortion. Levonorgestrel (Plan B) is intended for emergency contraception, and will not cause termination of a pregnancy that is already in place.

[Kikoku]

Excellent

[Dnite]

Gracias!