A 30-year-old patient is being seen at a healthcare clinic where she receives a prescription for hormone therapy as a form of birth control. The nurse counsels the patient not to take this medication in which of the following scenarios?

 

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Correct

- Smokes tobacco

- Has abdominal pain

- Has uterine cramps with menstruation

- Takes over-the-counter pain medications

Rationale

"Smokes tobacco" is correct. Oral contraceptives are hormone supplements used for birth control and to regulate menstrual cycles for some women. Most oral contraceptives are made up of estrogen, progestin or a combination of the two. Patients who take oral contraceptives should not smoke because smoking greatly increases the risk of cardiovascular adverse effects, including ischemic stroke and myocardial infarction. This risk increases even further as age increases.

"Has abdominal pain", "Has uterine cramps with menstruation" and "Takes over-the-counter pain medications" are incorrect because none of these circumstances are a contraindication with oral contraceptive use.

References:
Kroon, L., Pharm D. (2007). Drug Interactions With Smoking. Retrieved May 1, 2018, from https://www.medscape.com/viewarticle/562754_5

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