This is a case of a young mother, 26 y.o., para 2 gravida 2, with a normal physical exam who desires to have a more reliable form of contraception while continuing to breast feed her nine month old baby. She has a normal BMI with normal vital signs. Past medical history of mild hypertension during her first pregnancy and seasonal allergies are noted. She’s taking Allegra as needed for allergies, multivitamin with iron, and some chewable calcium. She has a known drug allergy to Sulfa. Family history is significant for hypertension and colon cancer. She tested negative for pregnancy on this visit. The treatment goals for Claudia today are to help her select a reliable method of contraception and to support her decision to continue breastfeeding…show more content… Patient also needs to know that the injection needs to be given every 12 weeks, give and take 1 week for it to be effective, but can be administered sooner if spotting occurs. She also has to understand that even though she has a negative pregnancy test she may have to come back during her menses to get the shot if she has had sexual intercourse within the last 14 days. DMPA also increases the risk for osteoporosis but switching to a contraceptive with estrogen is an option once she’s no longer breastfeeding. She can continue to take calcium and vitamin D supplements, and incorporate weight-bearing exercise to her work-out regimen to prevent osteoporosis (Edmunds & Mayhew, 2013). She also needs to be educated on the adverse effects of the medication such as “breast tenderness, allergy, headache, nervousness, dizziness, weakness, and fatigue” (Edmunds & Mayhew, 2013, p.627). Other less common adverse effects are cramping in the legs, vaginal inflammation, whitish vaginal discharge, difficulty sleeping, nausea, hot flash, decreased sexual desires, anorgasmia, and hypersensitivity (Edmunds & Mayhew,
