A patient is taking a combination oral contraceptive (OC) and tells the nurse that she is planning to undergo knee replacement surgery in 2 months. What will the nurse recommend for this pa-tient?
a. The patient should ask her provider about an OC with less progestin.
b. The patient should discuss an alternate method of birth control prior to surgery.
c. The patient should request an OC con-taining less estrogen after surgery.
d. The patient should take the OC at bedtime after her surgery to reduce side effects.
B
Patients taking an OC who undergo surgery in which immobilization increases the risk of post-operative thrombosis should stop taking the OC at least 4 weeks prior to surgery. The patient should discuss an alternate method of birth control with her provider. Estrogen, not progestin, increases the risk of thrombosis. The estrogen-containing OC should be stopped 4 weeks prior to surgery. Taking the OC at bedtime does not decrease the risk.
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