Module 7 Discussion The 15-Year-Old Patient Evaluation and Management Plan
University:
St. Thomas University
Module 7 Discussion The 15-Year-Old Patient Evaluation and Management Plan
Paper Instructions
You are seeing a 15-year-old female patient for a gynecological exam and to explore birth control options. The patient’s mother scheduled the appointment after learning that her daughter has become sexually active. The patient is current with all immunizations, including Gardasil, and has no significant health history that would contraindicate the use of birth control.
- This is the patient’s first gynecological exam, and she expresses feeling nervous and embarrassed that her mother has shared her sexual experience with strangers. Taking this into account, how would you begin the patient encounter?
- As you begin asking questions to determine the patient’s gynecological history, the patient appears frustrated and embarrassed and reminds you that she has only had sex one time. What should the patient understand about the importance of reviewing gynecological history?
- What are the most popular birth control methods prescribed in the United States? What determines the success or failure of a birth control method?
- The patient expresses a desire for the most effective form of birth control but is concerned about weight gain and other side effects. How should you respond to her concerns?
The patient seems unsure about the best option for birth control and asks if she can take some time to think about the choices. As the use of birth control is ultimately the patient’s choice, you offer to answer any questions and agree to a follow-up visit or call. The patient asks whether using a condom is okay if she decides to have sexual intercourse before selecting a method of birth control. What should you tell her?
Submission Instructions
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
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Sample Answer
Sensitive Gynaecological History and Examination
I would begin the encounter with the teenager by creating a good rapport through acknowledging her feeling of nervousness and embarrassment. I would assure her that despite the topic being uncomfortable, her feelings are normal (Wang et al., 2019). I would emphasize that my presence was to make sure she feels comfortable, and my aim was to ensure safe exam. I would ensure that I create a conducive environment to and build trust with her to ensure she feels safe.
I would inform her that gynaecological review is important to assess her risk sexually transmitted infections (STIs) and their long-term complications such as pelvic inflammatory diseases (Lamvu et al., 2021). It would help me to decide the best mode of family planning suitable for her. Gynaecological review evaluates the age of sexual debut and the number of sexual partners which are important in assessing ladies at increased risk for cervical cancer.
In the US the combined oral contraceptive pill is the most used birth control pill among women of reproductive age, it is followed closely by condoms, intrauterine devices and implants.
The effectiveness of a birth control method is influenced by consistent and correct use. User-dependent methods, like pills and condoms, rely on adherence to instructions. Conversely, provider-dependent methods, such as Intra-Uterine Devices and implants, offer higher efficacy as they are not subject to user error. Individual health factors, medications, and lifestyle can also impact the success of a chosen birth control method.
I would respond empathetically, acknowledging her concerns and explaining that individual responses to birth control methods vary (Ganti et al., 2019). I would discuss alternative options and their potential side effects, emphasizing that not everyone experiences weight gain. I would highlight the importance of open communication about any side effects during follow-up visits, ensuring adjustments can be made if needed.
I would affirm the importance of responsible and protected sexual activity. I would emphasize that using condoms is a valid and effective method for preventing both pregnancy and STIs (Wilkinson et al., 2022). I would remind her that while condoms offer dual protection, they are user-dependent and should be used consistently and correctly. I would encourage her to feel free to reach out with any further questions or concerns and reiterate the availability of follow-up visits to discuss and decide on a more long-term birth control method when she’s ready.
References
- Ganti, A. K., & Hillard, P. J. A. (2019). Family planning in adolescents. Current opinion in obstetrics & gynecology, 31(6), 447–451. https //doi.org/10.1097/GCO.0000000000000577
- Lamvu, G., Carrillo, J., Ouyang, C., & Rapkin, A. (2021). Chronic Pelvic Pain in Women A Review. JAMA, 325(23), 2381–2391. https //doi.org/10.1001/jama.2021.2631
- Wang, P., Ai, J., Davidson, P. M., Slater, T., Du, R., & Chen, C. (2019). Nurses’ attitudes, beliefs and practices on sexuality for cardiovascular care A cross-sectional study. Journal of clinical nursing, 28(5-6), 980–986. https //doi.org/10.1111/jocn.14692
- Wilkinson, T. A., Jenkins, K., Hawryluk, B. A., Moore, C. M., Wiehe, S. E., & Kottke, M. J. (2022). Dual Protection Messaging for Adolescents and Young Adults in the Setting of Over-the-Counter Hormonal Contraception A Human-Centered Design Approach. Journal of pediatric and adolescent gynecology, 35(6), 669–675. https //doi.org/10.1016/j.jpag.2022.08.009
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