A patient received a scheduled dose of depot medroxyprogesterone acetate (DMPA) 6 weeks ago. Today, the patient reports that a regular menstrual cycle is 2 weeks late. What is the first thing that should be done for this patient?
A) Perform a pregnancy test.
B) Provide prenatal counseling.
C) Discuss pregnancy termination options.
D) Explain side effects of the contraceptive.
A
Feedback:
Because the patient is receiving a contraceptive that could cause amenorrhea, and the patient's menstrual cycle is 2 weeks late, the first thing that should be done is a pregnancy test to determine if the patient is pregnant. The results of this test will determine the next course of action. Depot medroxyprogesterone acetate (DMPA) is a pregnancy category X medication, which means it should not be administered to someone who is pregnant. It is unclear if the patient was already pregnant when the last dose was provided 6 weeks prior to the current situation. It is premature to provide prenatal counseling. Depending on the results of the pregnancy test, the nurse may need to explain side effects of the contraceptive which include amenorrhea.
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