Question

B. Ellie is a 20-year-old female who presents to the college student health center requesting a prescription for birth control. She has been dating the same person for 4 months and has consistently used a condom when they have had intercourse. She is healthy. Her last menstrual period was 1 week prior to the visit. She weighs 124 pounds and her blood pressure is 114/72 mm Hg. She is requesting a prescription for the Depo Provera injection. 1. What is the plan of care for Ellie? 2. When can she receive her first injection? 3. What education & follow-up does she require?

please give patho of th le disease, drug of choice and dosage!

Answer 1

1. The plan of care for Ellie would include :-

- Health education about the different contraception available.

- Helping her to choose the best one

- Regular follow up

2. She can use backup methods until next period and then start depo provera according to regular patient instruction . The dose is 150 mg every three month deep intramuscular injection .

3. Health education :-

Depo-Provera is a well-known brand name for medroxyprogesterone acetate, a contraceptive injection for women that contains the hormone progestin. Depo-Provera is given as an injection every three months. Depo-Provera typically suppresses ovulation, keeping your ovaries from releasing an egg. Depo-Provera also thickens cervical mucus to keep sperm from reaching the egg.

Medroxyprogesterone acetate is also available in a lower dosage. This version is called Depo-SubQ Provera 104. While Depo-Provera is injected deep into the muscle, Depo-SubQ Provera 104 is injected just beneath the skin. It is recommended if :-

You don't want to take a birth control pill every day

You want or need to avoid using estrogen

You have health problems such as anemia, seizures, sickle cell disease, endometriosis or uterine fibroids.

# Benefits :-

Doesn't require daily action

Eliminates the need to interrupt sex for contraception

Decreases menstrual cramps and pain

Lessens menstrual blood flow, and in some cases stops menstruation

Decreases the risk of endometrial cancer

# Contraindications :-

Unexplained vaginal bleeding

Breast cancer

Liver disease

Sensitivity to any component of Depo-Provera

Risk factors for osteoporosis

A history of depression

A history of heart attack or stroke

In addition, tell your health care provider if you have diabetes or a history of heart disease or stroke.

Among the things to consider about Depo-Provera are:

You might have a delay in your return to fertility. After stopping Depo-Provera, it might take 10 months or more before you begin ovulating again. If you want to become pregnant in the next year or so, Depo-Provera might not be the right birth control method for you.

Depo-Provera doesn't protect against sexually transmitted infections. In fact, some studies suggest that hormonal contraceptives such as Depo-Provera might increase a woman's risk of chlamydia and HIV. It isn't known whether this association is due to the hormone or behavioral issues related to the use of reliable contraception.

It might affect bone mineral density. Research has suggested that Depo-Provera and Depo-SubQ Provera 104 might cause a loss of bone mineral density. This loss might be especially concerning in teens who haven't reached their peak bone mass. And it's not clear whether this loss is reversible.

Because of this, the Food and Drug Administration added strong warnings to the injection packaging cautioning that Depo-Provera and Depo-SubQ Provera 104 shouldn't be used for longer than two years. The warning also states that using these products might increase the risk of osteoporosis and bone fractures later in life.